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Teeth

Teeth

The formation of teeth, also known as odontogenesis, is a complex process that begins in utero, around the sixth week of embryonic development. There are three stages to this process: the bud stage, the cap stage, and the bell stage.
In the bud stage, the tooth germ (an aggregation of cells) starts to form in the developing jawbone. During the cap stage, the tooth germ differentiates into enamel organ, dental papilla, and dental sac, which will later develop into the tooth's enamel, dentin...

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Related Experiment Video

Updated: Aug 16, 2025

Guided Endodontics: Three-Dimensional Planning and Template-Aided Preparation of Endodontic Access Cavities

Guided Endodontics: Three-Dimensional Planning and Template-Aided Preparation of Endodontic Access Cavities

Published on: May 24, 2022

Maxillary Premolars with Four Canals: Case Series.

Calogero Bugea¹, Denise Irene Karin Pontoriero^2,3, Gaia Rosenberg⁴

¹Private Practice, Lungomare G. Galilei, 73014 Gallipoli, Italy.

Bioengineering (Basel, Switzerland)

|December 23, 2022

Summary

This case series details endodontic treatment for maxillary premolars with four canals, offering insights into managing complex root canal anatomy. Proper diagnosis and advanced techniques are crucial for successful outcomes in these challenging cases.

Keywords:

MEA technique anatomical variations canal coneless maxillary premolars root root canal anomalies root morphology upper premolars

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Area of Science:

Endodontics
Dentistry
Dental Anatomy

Background:

Maxillary premolars typically present with one or two root canals.
Complex root canal anatomy, such as four canals, poses significant challenges in endodontic treatment.
Understanding variations in root canal morphology is crucial for successful endodontic therapy.

Observation:

This case series presents five instances of maxillary premolars exhibiting four root canals (three buccal, one palatal).
Diverse endodontic treatment approaches were employed, including conservative preparation, hybrid shaping, endodontic microsurgery, and biomaterial application.
The study highlights the necessity of advanced tools and techniques for managing these complex cases.

Findings:

Successful endodontic treatment was achieved in all five cases of four-canal maxillary premolars.
The study demonstrates the feasibility of various treatment strategies for complex root canal systems.
Effective management relies on meticulous diagnosis and tailored treatment planning.

Implications:

This research enhances the understanding of rare maxillary premolar anatomy and its endodontic implications.
The findings provide valuable guidance for clinicians managing complex root canal systems.
Adoption of advanced technologies like dental operating microscopes is vital for predictable endodontic success in challenging anatomies.