*Root canal configurations of mandibular second molars in different populations.*

#### *Morphology of Root Canal System of Maxillary and Mandibular Molars DOI: http://dx.doi.org/10.5772/intechopen.84151*


**Table 7.**

**139**

**Figure 20.**

**Table 8.**

**Figure 21.**

**Figure 22.**

*root canal, (C) apical third of root canals.*

*root canal, (C) apical third of root canals.*

*root canal, (C) apical third of root canals.*

*Morphology of Root Canal System of Maxillary and Mandibular Molars*

**Root Type (1-1)**

**Type (2-1)**

**Type (1-2-1)**

Single 65.6 14.7 – 9.8 9.8 – – Mesial 59 24.2 2.7 9.8 3.9 – – Distal 99.2 0.8 – – – – –

Single 31.2 21.9 9.4 25 3.1 – 3.1 Mesial 54.1 17.4 13.8 3.7 7.4 – – Distal 92.7 1.8 2.7 – – – –

Single 55.6 22.2 11.1 – – 11.1 – Mesial 40.6 18.8 3.1 28.1 9.4 – – Distal 93.8 – – 3.1 3.1 – –

Single 42.7 3.6 – 2.4 2.4 – – Mesial 68.3 5 8.3 3.3 11.7 – – Distal 100 – – – – – –

**Type (2-2)**

**Type (1-2)**

**Type (2-1-2)** **Type (3-3)**

single-rooted third molars (**Table 8**) [46, 49, 50, 71]. The incidence of C-shaped canals was reported in Thailand (11%) [70], Iran (3.3%) [71], and China (3.3%) (**Figure 23**) [50]. Root canal shape of mandibular third molar varies per root.

*Mandibular third molar with one root and two canals(A) coronal third of root canals, (B) middle third of* 

*Mandibular third molar with two roots and two canals(A) coronal third of root canals, (B) middle third of* 

*Mandibular third molar with three roots and three canals(A) coronal third of root canals, (B) middle third of* 

*DOI: http://dx.doi.org/10.5772/intechopen.84151*

**(Year)**

Turkey (2011)

Iran (2012)

Jordan (2016)

China (2018)

*Root canal configuration of maxillary third molar in different populations.*

**Author(s) Country** 

Sert et al. [49]

Kuzekanani et al. [71]

Ahmad et al. [46]

Zhang et al. [50]

*The number of roots and root canals of mandibular third molars in different populations.*


*Morphology of Root Canal System of Maxillary and Mandibular Molars DOI: http://dx.doi.org/10.5772/intechopen.84151*

#### **Table 8.**

*Human Teeth - Key Skills and Clinical Illustrations*

**Number of canals**

**138**

**Author(s)** Sidow et al. [44]

Gulabivala et al. [13]

Gulabivala et al. [70]

Sert et al. [49] Kuzekanani et al. [71]

Cosić et al. [47]

Ahmad et al. [46]

Zhang et al. [50]

Razumova et al. [40]

**Table 7.**

Russia (2018) *The number of roots and root canals of mandibular third molars in different populations.*

CBCT

210

20

80

–

–

0.5

40.9

58.6

–

–

–

Iran (2012) Croatia (2013)

Jordan (2016) China (2018)

Clearing Micro KT

130

47.7

46.1

5.4

0.8

–

–

–

–

–

–

70

14.3

74.3

8.6

2.9

7.1

38.6

45.7

8.6

–

–

Sectioning

50

56

44

–

–

4

6

90

–

–

–

Clearing

150

21.4

72.6

5.3

0.7

10

52

32.7

5.3

–

–

Thai (2002) Turkey (2011)

Clearing

370

24.9

69.5

5.4

0.3

10.8

52.7

17.3

18.6

0.5

–

Clearing

173

11.6

86.7

21.2

0.6

6.4

64.1

28.3

5.2

–

–

Burmese (2001)

Clearing

58

–

100

–

–

1.7

51.7

44.8

1.7

–

–

USA (2000)

Clearing

150

17

77

5

1

7.3

16.7

55.3

16.7

3.3

0.7

**Country (year)**

**Type of study**

**Number of teeth**

**1**

**2**

**3**

**4**

**1**

**2**

**3**

**4**

**5**

**6**

**Number of roots**

*Root canal configuration of maxillary third molar in different populations.*

#### **Figure 20.**

*Mandibular third molar with two roots and two canals(A) coronal third of root canals, (B) middle third of root canal, (C) apical third of root canals.*

**Figure 21.**

*Mandibular third molar with three roots and three canals(A) coronal third of root canals, (B) middle third of root canal, (C) apical third of root canals.*

#### **Figure 22.**

*Mandibular third molar with one root and two canals(A) coronal third of root canals, (B) middle third of root canal, (C) apical third of root canals.*

single-rooted third molars (**Table 8**) [46, 49, 50, 71]. The incidence of C-shaped canals was reported in Thailand (11%) [70], Iran (3.3%) [71], and China (3.3%) (**Figure 23**) [50]. Root canal shape of mandibular third molar varies per root.

#### **Figure 23.**

*Mandibular third molar with C-shaped canal(A) coronal third of root canals, (B) middle third of root canal, (C) apical third of root canals.*

#### **5. Conclusion**

This chapter summarized the root canal system of the maxillary and mandibular molars in different populations. Root canal system of the molar teeth is so complex and unpredictable. It varies among populations and even in individuals in same population. The maxillary first and second molars have in the most common form three roots with four canals. The maxillary third molar may have from one to five roots with different numbers of canals ranging from one to six canals. Mandibular molars in the most common form have two roots with three canals. C-shaped canals are mostly common in mandibular second molars. Clinicians should pay attention to the additional canals and additional configurations when preparing for the root canal treatment, since knowledge of the basic root and root canal morphology as well as possible variation in anatomy of the root canal system is an important factor to achieve successful root canal treatment.

#### **Author details**

Svetlana Razumova, Anzhela Brago, Haydar Barakat\* and Ammar Howijieh Department of Propaedeutics of Dental Diseases of Medical Institute, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia

\*Address all correspondence to: dr.haydarbarakat@yahoo.com

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**141**

*Morphology of Root Canal System of Maxillary and Mandibular Molars*

root canal configuration. Journal of Clinical and Diagnostic Research.

[9] Weine FS, Healey HJ, Gerstein H, Evanson L. Canal configuration in the mesiobuccal root of the maxillary first molar and its endodontic significance. Oral Surgery, Oral Medicine, and Oral

[10] Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surgery, Oral Medicine, and Oral Pathology. 1984;**58**:589-599

[11] Cleghorn BM, Christie WH, Dong CC. The root and root canal morphology of the human mandibular second premolar: A literature review. Journal of Endodontia. 2007;**33**(9):1031-1037

[12] Kartal N, Yanıkoğlu FÇ. Root canal morphology of mandibular incisors. Journal of Endodontia.

[13] Gulabivala K, Aung T, Alavi A, Ng YL. Root and canal morphology of Burmese mandibular molars. International Endodontic Journal.

[14] Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent

[15] Peiris H, Pitakotuwage T, Takahashi M, Sasaki K, Kanazawa E. Root canal morphology of mandibular permanent molars at different ages. International Endodontic Journal. 2008;**41**:828-835

[16] Al-Qudah AA, Awawdeh LA. Root and canal morphology of mandibular first and second molar teeth in a Jordanian population. International Endodontic Journal. 2009;**42**:775-784

teeth by gender in the Turkish population. Journal of Endodontia.

1992;**S18**:562-564

2001;**34**:359-370

2004;**30**:391-398

2018;**12**(5):ZE01-ZE05

Pathology. 1969;**28**:419-425

*DOI: http://dx.doi.org/10.5772/intechopen.84151*

[1] Rahimi S, Ghasemi N. Maxillary first molar with two root canals. Sultan Qaboos University Medical Journal.

[2] Blinov VS, Kartashov MV, Zholudev SE, Zornikova OS. Estimation of the cone-beam computed tomography in diagnostics of the molar root system anatomy of the mandible and maxilla. Radiology—Practice. 2016;**59**(5):6-15

[3] Toure B, Faye B, Kane AW, Lo CM, Niang B, Boucher Y. Analysis of reasons for extraction of endodontically treated teeth: A prospective study. Journal of Endodontia. 2011;**37**:1512-1515

[4] Gu Y, Lu Q, Wang H, Ding Y, Wang P, Ni L. Root canal morphology of permanent three rooted mandibular first molars—Part I: Pulp floor and root canal system. Journal of Endodontia.

[5] Filpo-Perez C, Bramante CM, Villas-Boas MH, Duarte MAH, Versiani MA, Ordinola-Zapata R. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molars. Journal of

Endodontia. 2015;**41**:231-236

[6] Ballullaya SV, Vemuri S, Kumar PR. Variable permanent mandibular first molar: Review of literature. Journal of Conservative Dentistry.

[7] Dinakar C, Shetty UA, Salian VV, Shetty P. Root canal morphology of maxillary first premolars using the clearing technique in a south Indian population: An in vitro study. International Journal of Applied & Basic Medical Research. 2018;**8**(3):143-147

[8] Bansal R, Hegde S, Astekar MS. Classification of root canal configurations: A review and a new proposal of nomenclature system for

2013;**13**(2):346-349

**References**

2010;**36**:1341-1346

2013;**16**:99-110

*Morphology of Root Canal System of Maxillary and Mandibular Molars DOI: http://dx.doi.org/10.5772/intechopen.84151*

#### **References**

*Human Teeth - Key Skills and Clinical Illustrations*

to achieve successful root canal treatment.

**140**

**Author details**

**5. Conclusion**

*(C) apical third of root canals.*

**Figure 23.**

provided the original work is properly cited.

© 2019 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/ by/3.0), which permits unrestricted use, distribution, and reproduction in any medium,

Svetlana Razumova, Anzhela Brago, Haydar Barakat\* and Ammar Howijieh Department of Propaedeutics of Dental Diseases of Medical Institute, Peoples' Friendship University of Russia (RUDN University), Moscow, Russia

This chapter summarized the root canal system of the maxillary and mandibular molars in different populations. Root canal system of the molar teeth is so complex and unpredictable. It varies among populations and even in individuals in same population. The maxillary first and second molars have in the most common form three roots with four canals. The maxillary third molar may have from one to five roots with different numbers of canals ranging from one to six canals. Mandibular molars in the most common form have two roots with three canals. C-shaped canals are mostly common in mandibular second molars. Clinicians should pay attention to the additional canals and additional configurations when preparing for the root canal treatment, since knowledge of the basic root and root canal morphology as well as possible variation in anatomy of the root canal system is an important factor

*Mandibular third molar with C-shaped canal(A) coronal third of root canals, (B) middle third of root canal,* 

\*Address all correspondence to: dr.haydarbarakat@yahoo.com

[1] Rahimi S, Ghasemi N. Maxillary first molar with two root canals. Sultan Qaboos University Medical Journal. 2013;**13**(2):346-349

[2] Blinov VS, Kartashov MV, Zholudev SE, Zornikova OS. Estimation of the cone-beam computed tomography in diagnostics of the molar root system anatomy of the mandible and maxilla. Radiology—Practice. 2016;**59**(5):6-15

[3] Toure B, Faye B, Kane AW, Lo CM, Niang B, Boucher Y. Analysis of reasons for extraction of endodontically treated teeth: A prospective study. Journal of Endodontia. 2011;**37**:1512-1515

[4] Gu Y, Lu Q, Wang H, Ding Y, Wang P, Ni L. Root canal morphology of permanent three rooted mandibular first molars—Part I: Pulp floor and root canal system. Journal of Endodontia. 2010;**36**:1341-1346

[5] Filpo-Perez C, Bramante CM, Villas-Boas MH, Duarte MAH, Versiani MA, Ordinola-Zapata R. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molars. Journal of Endodontia. 2015;**41**:231-236

[6] Ballullaya SV, Vemuri S, Kumar PR. Variable permanent mandibular first molar: Review of literature. Journal of Conservative Dentistry. 2013;**16**:99-110

[7] Dinakar C, Shetty UA, Salian VV, Shetty P. Root canal morphology of maxillary first premolars using the clearing technique in a south Indian population: An in vitro study. International Journal of Applied & Basic Medical Research. 2018;**8**(3):143-147

[8] Bansal R, Hegde S, Astekar MS. Classification of root canal configurations: A review and a new proposal of nomenclature system for root canal configuration. Journal of Clinical and Diagnostic Research. 2018;**12**(5):ZE01-ZE05

[9] Weine FS, Healey HJ, Gerstein H, Evanson L. Canal configuration in the mesiobuccal root of the maxillary first molar and its endodontic significance. Oral Surgery, Oral Medicine, and Oral Pathology. 1969;**28**:419-425

[10] Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surgery, Oral Medicine, and Oral Pathology. 1984;**58**:589-599

[11] Cleghorn BM, Christie WH, Dong CC. The root and root canal morphology of the human mandibular second premolar: A literature review. Journal of Endodontia. 2007;**33**(9):1031-1037

[12] Kartal N, Yanıkoğlu FÇ. Root canal morphology of mandibular incisors. Journal of Endodontia. 1992;**S18**:562-564

[13] Gulabivala K, Aung T, Alavi A, Ng YL. Root and canal morphology of Burmese mandibular molars. International Endodontic Journal. 2001;**34**:359-370

[14] Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. Journal of Endodontia. 2004;**30**:391-398

[15] Peiris H, Pitakotuwage T, Takahashi M, Sasaki K, Kanazawa E. Root canal morphology of mandibular permanent molars at different ages. International Endodontic Journal. 2008;**41**:828-835

[16] Al-Qudah AA, Awawdeh LA. Root and canal morphology of mandibular first and second molar teeth in a Jordanian population. International Endodontic Journal. 2009;**42**:775-784

[17] Kim S, Pecora G, Rubinstein R, Dorscher-Kim J. Color Atlas of Microsurgery in Endodontics. Philadelphia: WB Saunders; 2001

[18] Barbizam JVB, Ribeiro RG. Unusual anatomy of permanent maxillary molars. Journal of Endodontia. 2004;**30**(9):668-671

[19] Alrahabi M, Sohail Zafar M. Evaluation of root canal morphology of maxillary molars using cone beam computed tomography. Pakistan Journal of Medical Sciences. 2015;**31**(2):426-430

[20] Tian XM, Yang XW, Qian L, Wei B, Gong Y. Analysis of the root and canal morphologies in maxillary first and second molars in a Chinese population using cone-beam computed tomography. Journal of Endodontia. 2016;**42**(5):696-701. DOI: 10.1016/j. joen.2016.01.017

[21] Naseri M, Safi Y, Akbarzadeh Baghban A, Khayat A, Eftekhar L. Survey of anatomy and root canal morphology of maxillary first molars regarding age and gender in an Iranian population using cone-beam computed tomography. Iranian Endodontic Journal. 2016;**11**(4):298-303

[22] Zheng QH, Wang Y, Zhou XD, Wang Q, Zheng GN, Huang DM. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. Journal of Endodontia. 2010;**36**(9):1480-1484

[23] Guo J, Vahidnia A, Sedghizadeh P, Enciso R. Evaluation of root and canal morphology of maxillary permanent first molars in a North American population by cone-beam computed tomography. Journal of Endodontia. 2014;**40**(5):635-639

[24] Singh S, Pawar M. Root canal morphology of South Asian Indian maxillary molar teeth. European Journal of Dentistry. 2015;**9**(1):133-144. DOI: 10.4103/1305-7456.149662

[25] Razumova S, Brago A, Khaskhanova L, Barakat H, Howijieh A. Evaluation of anatomy and root canal morphology of the maxillary first molar using the cone-beam computed tomography among residents of the Moscow region. Contemporary Clinical Dentistry. 2018;**9**(Suppl 1):S133-S136

[26] Patil AC, Ramesh HG, Yelamali S. Management of a permanent maxillary first molar with two disto buccal canals with the aid of spiral computed tomography: A case report. Journal of Clinical and Experimental Dentistry. 2010;**2**(3):e153-e156

[27] Cantatore G, Berutti E, Castellucci A. Missed anatomy: Frequency and clinical impact. Endodontic Topics. 2009;**15**:3-31

[28] Olczak K, Pawlicka H. The morphology of maxillary first and second molars analyzed by cone-beam computed tomography in a Polish population. BMC Medical Imaging. 2017;**17**:68

[29] Imura N, Hata GI, Toda T. Two canals in mesiobuccal roots of maxillary molars. International Endodontic Journal. 1998;**3**:410-414

[30] Martins JNR, Marques D, Mata A, Caramês J. Root and root canal morphology of the permanent dentition in a Caucasian population: A conebeam computed tomography study. International Endodontic Journal. 2017;**50**:1013-1026

[31] Neelakantan P, Subbarao C, Ahuja R, Subbarao CV, Gutmann JL. Conebeam computed tomography study of root and canal morphology of maxillary first and second molars in an Indian population. Journal of Endodontia. 2010;**36**(10):1622-1627

**143**

2017;**45**(2):830-842

*Morphology of Root Canal System of Maxillary and Mandibular Molars*

[39] Ghasemi N, Rahimi S, Shahi S, Samiei M, Frough Reyhani M, Ranjkesh B. A review on root anatomy and canal configuration of the maxillary second molars. Iranian Endodontic Journal.

[40] Razumova S, Brago A, Khaskhanova L, Howijieh A, Barakat H, Manvelyan A. A cone-beam computed tomography scanning of the root canal system of permanent teeth among the Moscow population. International Journal of Dentistry. 2018;**2018**:2615746

[41] Weng XL, Yu SB, Zhao SL, Wang HG, Mu T, Tang RY, et al. Root canal morphology of permanent maxillary teeth in the Han nationality in Chinese Guanzhong area: A new modified root canal staining technique. Journal of Endodontia. 2009;**35**(5):651-656

[42] Kalender A, Celikten B, Tufenkci P, Aksoy U, Basmacı F, Kelahmet U, et al. Cone beam computed tomography evaluation of maxillary molar root canal morphology in a Turkish Cypriot population. Biotechnology & Biotechnological Equipment.

2016;**30**(1):145-150

2018;**13**(3):373-380

2000;**26**(11):675-678

2002;**35**:478-485

[43] Naseri M, Ali Mozayeni M, Safi Y, Heidarnia M, Akbarzadeh Baghban A, Norouzi N. Root canal morphology of maxillary second molars according to age and gender in a selected Iranian population: A cone-beam computed tomography evaluation. Iranian Endodontic Journal.

[44] Sidow SJ, West LA, Liewehr FR, Loushine RJ. Root canal morphology of human maxillary and mandibular third molars. Journal of Endodontia.

[45] Alavi AM, Opasanon A, Ng YL, Gulabivala K. Root and canal morphology of Thai maxillary molars. International Endodontic Journal.

2017;**12**(1):1-9

*DOI: http://dx.doi.org/10.5772/intechopen.84151*

[32] Ghobashy AM, Nagy MM, Bayoumi AA. Evaluation of root and canal morphology of maxillary permanent molars in an Egyptian population by cone-beam computed tomography. Journal of Endodontia.

[33] Pérez-Heredia M, Ferrer-Luque CM, Bravo M, Castelo-Baz P, Ruíz-Piñón M, Baca P. Cone-beam computed tomographic study of root anatomy and canal configuration of molars in a Spanish population. Journal of Endodontia. 2017;**43**(9):1511-1516. DOI:

[34] Ratanajirasut R, Panichuttra A, Panmekiate S. A cone-beam computed tomographic study of root and canal morphology of maxillary first and second permanent molars in a Thai population. Journal of Endodontia. 2018;**44**(1):56-61. DOI: 10.1016/j.

[35] Rezaeian M, Rouhani Tonekaboni M, Iranmanesh F. Evaluating the root canal morphology of permanent maxillary first molars in Iranian

population. Iranian Endodontic Journal.

[36] Zhu Z, Zhao SL. Maxillary second molar with five root canals: A case report. Shanghai Kou Qiang Yi Xue.

[37] Kottoor J, Hemamalathi S, Sudha R, et al. Maxillary second molar with 5 roots and 5 canals evaluated using cone beam computerized tomography: A case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2010;**109**:e162-e165

[38] Wu D, Zhang G, Liang R, Zhou G, Wu Y, Sun C, et al. Root and canal morphology of maxillary second molars by cone-beam computed tomography in a native Chinese population. The Journal of International Medical Research.

2017;**43**(7):1089-1092

10.1016/j.joen.2017.03.026

joen.2017.08.020

2018;**13**(1):78-82

2011;**20**:219-221

*Morphology of Root Canal System of Maxillary and Mandibular Molars DOI: http://dx.doi.org/10.5772/intechopen.84151*

[32] Ghobashy AM, Nagy MM, Bayoumi AA. Evaluation of root and canal morphology of maxillary permanent molars in an Egyptian population by cone-beam computed tomography. Journal of Endodontia. 2017;**43**(7):1089-1092

*Human Teeth - Key Skills and Clinical Illustrations*

maxillary molar teeth. European Journal of Dentistry. 2015;**9**(1):133-144. DOI:

[25] Razumova S, Brago A, Khaskhanova L, Barakat H, Howijieh A. Evaluation of anatomy and root canal morphology of the maxillary first molar using the cone-beam computed tomography among residents of the Moscow region. Contemporary Clinical Dentistry. 2018;**9**(Suppl 1):S133-S136

[26] Patil AC, Ramesh HG, Yelamali S. Management of a permanent maxillary first molar with two disto buccal canals with the aid of spiral computed tomography: A case report. Journal of Clinical and Experimental Dentistry. 2010;**2**(3):e153-e156

[27] Cantatore G, Berutti E, Castellucci A. Missed anatomy: Frequency and clinical impact. Endodontic Topics.

[28] Olczak K, Pawlicka H. The morphology of maxillary first and second molars analyzed by cone-beam computed tomography in a Polish population. BMC Medical Imaging.

[29] Imura N, Hata GI, Toda T. Two canals in mesiobuccal roots of maxillary molars. International Endodontic

[30] Martins JNR, Marques D, Mata A, Caramês J. Root and root canal morphology of the permanent dentition in a Caucasian population: A conebeam computed tomography study. International Endodontic Journal.

[31] Neelakantan P, Subbarao C, Ahuja R, Subbarao CV, Gutmann JL. Conebeam computed tomography study of root and canal morphology of maxillary first and second molars in an Indian population. Journal of Endodontia.

Journal. 1998;**3**:410-414

2017;**50**:1013-1026

2010;**36**(10):1622-1627

2009;**15**:3-31

2017;**17**:68

10.4103/1305-7456.149662

[17] Kim S, Pecora G, Rubinstein R, Dorscher-Kim J. Color Atlas of Microsurgery in Endodontics. Philadelphia: WB Saunders; 2001

[18] Barbizam JVB, Ribeiro RG. Unusual anatomy of permanent maxillary molars. Journal of Endodontia.

morphology of maxillary molars using cone beam computed tomography. Pakistan Journal of Medical Sciences.

2004;**30**(9):668-671

2015;**31**(2):426-430

joen.2016.01.017

[19] Alrahabi M, Sohail Zafar M. Evaluation of root canal

[20] Tian XM, Yang XW, Qian L, Wei B, Gong Y. Analysis of the root and canal morphologies in maxillary first and second molars in a Chinese population using cone-beam computed tomography. Journal of Endodontia. 2016;**42**(5):696-701. DOI: 10.1016/j.

[21] Naseri M, Safi Y, Akbarzadeh Baghban A, Khayat A, Eftekhar L. Survey of anatomy and root canal morphology of maxillary first molars regarding age and gender in an Iranian population using cone-beam computed tomography. Iranian Endodontic Journal. 2016;**11**(4):298-303

[22] Zheng QH, Wang Y, Zhou XD, Wang Q, Zheng GN, Huang DM. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. Journal of Endodontia.

[23] Guo J, Vahidnia A, Sedghizadeh P, Enciso R. Evaluation of root and canal morphology of maxillary permanent first molars in a North American population by cone-beam computed tomography. Journal of Endodontia.

[24] Singh S, Pawar M. Root canal morphology of South Asian Indian

2010;**36**(9):1480-1484

2014;**40**(5):635-639

**142**

[33] Pérez-Heredia M, Ferrer-Luque CM, Bravo M, Castelo-Baz P, Ruíz-Piñón M, Baca P. Cone-beam computed tomographic study of root anatomy and canal configuration of molars in a Spanish population. Journal of Endodontia. 2017;**43**(9):1511-1516. DOI: 10.1016/j.joen.2017.03.026

[34] Ratanajirasut R, Panichuttra A, Panmekiate S. A cone-beam computed tomographic study of root and canal morphology of maxillary first and second permanent molars in a Thai population. Journal of Endodontia. 2018;**44**(1):56-61. DOI: 10.1016/j. joen.2017.08.020

[35] Rezaeian M, Rouhani Tonekaboni M, Iranmanesh F. Evaluating the root canal morphology of permanent maxillary first molars in Iranian population. Iranian Endodontic Journal. 2018;**13**(1):78-82

[36] Zhu Z, Zhao SL. Maxillary second molar with five root canals: A case report. Shanghai Kou Qiang Yi Xue. 2011;**20**:219-221

[37] Kottoor J, Hemamalathi S, Sudha R, et al. Maxillary second molar with 5 roots and 5 canals evaluated using cone beam computerized tomography: A case report. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 2010;**109**:e162-e165

[38] Wu D, Zhang G, Liang R, Zhou G, Wu Y, Sun C, et al. Root and canal morphology of maxillary second molars by cone-beam computed tomography in a native Chinese population. The Journal of International Medical Research. 2017;**45**(2):830-842

[39] Ghasemi N, Rahimi S, Shahi S, Samiei M, Frough Reyhani M, Ranjkesh B. A review on root anatomy and canal configuration of the maxillary second molars. Iranian Endodontic Journal. 2017;**12**(1):1-9

[40] Razumova S, Brago A, Khaskhanova L, Howijieh A, Barakat H, Manvelyan A. A cone-beam computed tomography scanning of the root canal system of permanent teeth among the Moscow population. International Journal of Dentistry. 2018;**2018**:2615746

[41] Weng XL, Yu SB, Zhao SL, Wang HG, Mu T, Tang RY, et al. Root canal morphology of permanent maxillary teeth in the Han nationality in Chinese Guanzhong area: A new modified root canal staining technique. Journal of Endodontia. 2009;**35**(5):651-656

[42] Kalender A, Celikten B, Tufenkci P, Aksoy U, Basmacı F, Kelahmet U, et al. Cone beam computed tomography evaluation of maxillary molar root canal morphology in a Turkish Cypriot population. Biotechnology & Biotechnological Equipment. 2016;**30**(1):145-150

[43] Naseri M, Ali Mozayeni M, Safi Y, Heidarnia M, Akbarzadeh Baghban A, Norouzi N. Root canal morphology of maxillary second molars according to age and gender in a selected Iranian population: A cone-beam computed tomography evaluation. Iranian Endodontic Journal. 2018;**13**(3):373-380

[44] Sidow SJ, West LA, Liewehr FR, Loushine RJ. Root canal morphology of human maxillary and mandibular third molars. Journal of Endodontia. 2000;**26**(11):675-678

[45] Alavi AM, Opasanon A, Ng YL, Gulabivala K. Root and canal morphology of Thai maxillary molars. International Endodontic Journal. 2002;**35**:478-485

[46] Ahmad IA, Azzeh MM, Zwiri AM, Abu Haija MS, Diab MM. Root and root canal morphology of third molars in a Jordanian subpopulation. Saudi Endodontic Journal. 2016;**6**:113-121

[47] Cosić J, Galić N, Vodanović M, Njemirovskij V, Segović S, Pavelić B, et al. An in vitro morphological investigation of the endodontic spaces of third molars. Collegium Antropologicum. 2013;**37**(2):437-442

[48] Ng YL, Aung TH, Alavi A, Gulabivala K. Root and canal morphology of Burmese maxillary molars. International Endodontic Journal. 2001;**34**:620-630

[49] Sert S, Sahinkesen G, Topçu FT, Eroglu SE, Oktay EA. Root canal configurations of third molar teeth. A comparison with first and second molars in the Turkish population. Australian Endodontic Journal. 2011;**37**:109-117

[50] Zhang W, Tang Y, Liu C, Shen Y, Feng X, Gu Y. Root and root canal variations of the human maxillary and mandibular third molars in a Chinese population: A micro-computed tomographic study. Archives of Oral Biology. 2018;**95**:134-140. DOI: 10.1016

[51] Kim SY, Kim BS, Woo J, Kim Y. Morphology of mandibular first molars analyzed by cone-beam computed tomography in a Korean population: Variations in the number of roots and canal. Journal of Endodontia. 2013;**39**(12):1516-1521

[52] Celikten B, Tufenkci P, Aksoy U, Kalender A, Kermeoglu F, Dabaj P, et al. Cone beam CT evaluation of mandibular molar root canal morphology in a Turkish Cypriot population. Clinical Oral Investigations. 2016;**20**(8):2221-2226

[53] Chourasia HR, Meshram GK, Warhadpande M, Dakshindas D. Root canal morphology of mandibular first permanent molars in an Indian population. International Journal of Dentistry. 2012;**2012**:745152

[54] Muriithi NJ, Maina SW, Okoth J, Gathece LW. Internal root morphology in mandibular first permanent molars in a Kenyan population. East African Medical Journal. 2012;**89**(5):166-171

[55] Zhang X, Xiong S, Ma Y, et al. A cone-beam computed tomographic study on mandibular first molars in a Chinese subpopulation. PLoS One. 2015;**10**(8):e0134919. DOI: 10.1371/ journal.pone.0134919

[56] Torres A, Jacobs R, Lembrechts P, Brizuela C, Cabrera C, Concha G, et al. Characterization of mandibular molar root and canal morphology using cone beam computed tomography and its variability in Belgian and Chilean population samples. Imaging Science in Dentistry. 2015;**45**:95-101

[57] Madani ZS, Mehraban N, Moudi E, Bijani A. Root and canal morphology of mandibular molars in a selected Iranian population using cone-beam computed tomography. Iranian Endodontic Journal. 2017;**12**(2):143-148

[58] Gambarini G, Piasecki L, Ropini P, Miccoli G, Di Nardo D, Testarelli L. Cone-beam computed tomographic analysis on root and canal morphology of mandibular first permanent molar among multiracial population in Western European population. European Journal of Dentistry. 2018;**12**(3):434-438

[59] Zhang R, Wang H, Tian YY, Yu X, Hu T, Dummer PM. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals. International Endodontic

**145**

*Morphology of Root Canal System of Maxillary and Mandibular Molars*

using microcomputed tomography and clearing technique. Acta Odontologica

[67] Rogazkyn D, Metzger Z, Solomonov M. The prevalence and asymmetry of C-shaped root canals in second mandibular molars in a European-Russian population: A cone-beam computed tomography study in vivo. International Journal of Endodontic

Scandinavica. 2015;**73**:427-432

Rehabilitation. 2016;**2**:12-16

[68] Neelakantan P, Subbarao C,

Subbarao CV, Ravindranath M. Root and canal morphology of mandibular second molars in an Indian population. Journal of Endodontia. 2010;**36**(8):1319-1322. DOI: 10.1016/j.joen.2010.04.001

[69] Ceperuelo D, Lozano M, Duran-Sindreu F, Mercade M. Root canal morphology of chalcolithic and early bronze age human populations of el mirador cave (sierra de atapuerca, Spain). The Anatomical Record.

[70] Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. International Endodontic Journal. 2002;**35**:56-62

[71] Kuzekanani M, Haghani J, Nosrati H. Root and canal morphology of mandibular third molars in an Iranian population. Journal of Dental Research, Dental Clinics, Dental Prospects.

2014;**297**:2342-2348

2012;**6**:85-88

*DOI: http://dx.doi.org/10.5772/intechopen.84151*

[60] Alfawaz H, Alqedairi A, Alkhayyal AK, Almobarak AA, Alhusain MF, Martins JNR. Prevalence of C-shaped canal system in mandibular first and second molars in a Saudi population assessed via cone beam computed tomography: A retrospective study. Clinical Oral Investigations. Jan

Journal. 2011;**44**(11):990-999. DOI: 10.1111/j.1365-2591.2011.01904.x

2019;**23**(1):107-112

2017;**21**(9):2801-2809

2016;**49**(2):136-144

2014;**28**:39-45

2010;**2009**:634567

[61] Pawar AM, Pawar M, Kfir A, Singh S, Salve P, Thakur B, et al. Root canal morphology and variations in mandibular second molar teeth of an Indian population: An in vivo cone-beam computed tomography analysis. Clinical Oral Investigations.

[62] Kim SY, Kim BS, Kim Y. Mandibular second molar root canal morphology and variants in a Korean subpopulation. International Endodontic Journal.

[63] Silva EJ, Nejaim Y, Silva AV, Haiter-Neto F, Cohenca N. Evaluation of root canal configuration of mandibular molars in a Brazilian population by using cone-beam computed tomography: An in vivo study. Journal of Endodontia. 2013;**39**:849-852

[64] Ladeira DB, Cruz AD, Freitas DQ, Almeida SM. Prevalence of C-shaped root canal in a Brazilian subpopulation: A cone-beam computed tomography analysis. Brazilian Oral Research.

[65] Scarfe WC, Levin MD, Gane D, Farman AG. Use of cone beam computed tomography in endodontics. International Journal of Dentistry.

[66] Kim Y, Perinpanayagam H, Lee JK, et al. Comparison of mandibular first molar mesial root canal morphology

*Morphology of Root Canal System of Maxillary and Mandibular Molars DOI: http://dx.doi.org/10.5772/intechopen.84151*

Journal. 2011;**44**(11):990-999. DOI: 10.1111/j.1365-2591.2011.01904.x

*Human Teeth - Key Skills and Clinical Illustrations*

[53] Chourasia HR, Meshram GK, Warhadpande M, Dakshindas D. Root canal morphology of mandibular first permanent molars in an Indian population. International Journal of Dentistry. 2012;**2012**:745152

[54] Muriithi NJ, Maina SW, Okoth J, Gathece LW. Internal root morphology in mandibular first permanent molars in a Kenyan population. East African Medical Journal. 2012;**89**(5):166-171

[55] Zhang X, Xiong S, Ma Y, et al. A cone-beam computed tomographic study on mandibular first molars in a Chinese subpopulation. PLoS One. 2015;**10**(8):e0134919. DOI: 10.1371/

[56] Torres A, Jacobs R, Lembrechts P, Brizuela C, Cabrera C, Concha G, et al. Characterization of mandibular molar root and canal morphology using cone beam computed tomography and its variability in Belgian and Chilean population samples. Imaging Science in

[57] Madani ZS, Mehraban N, Moudi E, Bijani A. Root and canal morphology of mandibular molars in a selected Iranian population using cone-beam computed tomography. Iranian Endodontic Journal. 2017;**12**(2):143-148

[58] Gambarini G, Piasecki L, Ropini P, Miccoli G, Di Nardo D, Testarelli L. Cone-beam computed tomographic analysis on root and canal morphology

of mandibular first permanent molar among multiracial population in Western European population. European Journal of Dentistry.

[59] Zhang R, Wang H, Tian YY, Yu X, Hu T, Dummer PM. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals. International Endodontic

2018;**12**(3):434-438

journal.pone.0134919

Dentistry. 2015;**45**:95-101

[46] Ahmad IA, Azzeh MM, Zwiri AM, Abu Haija MS, Diab MM. Root and root canal morphology of third molars in a Jordanian subpopulation.

[47] Cosić J, Galić N, Vodanović M, Njemirovskij V, Segović S, Pavelić B, et al. An in vitro morphological investigation of the endodontic spaces of third molars. Collegium Antropologicum. 2013;**37**(2):437-442

[48] Ng YL, Aung TH, Alavi A, Gulabivala K. Root and canal morphology of Burmese maxillary molars. International Endodontic

[49] Sert S, Sahinkesen G, Topçu FT, Eroglu SE, Oktay EA. Root canal configurations of third molar teeth. A comparison with first and second molars in the Turkish population. Australian Endodontic Journal.

[50] Zhang W, Tang Y, Liu C, Shen Y, Feng X, Gu Y. Root and root canal variations of the human maxillary and mandibular third molars in a Chinese population: A micro-computed tomographic study. Archives of Oral Biology. 2018;**95**:134-140. DOI:

[51] Kim SY, Kim BS, Woo J, Kim Y. Morphology of mandibular first molars analyzed by cone-beam computed tomography in a Korean population: Variations in the number of roots and canal. Journal of Endodontia.

[52] Celikten B, Tufenkci P, Aksoy U, Kalender A, Kermeoglu F, Dabaj P, et al. Cone beam CT evaluation of mandibular molar root canal morphology in a Turkish Cypriot population. Clinical Oral Investigations.

2013;**39**(12):1516-1521

2016;**20**(8):2221-2226

Journal. 2001;**34**:620-630

2011;**37**:109-117

10.1016

Saudi Endodontic Journal.

2016;**6**:113-121

**144**

[60] Alfawaz H, Alqedairi A, Alkhayyal AK, Almobarak AA, Alhusain MF, Martins JNR. Prevalence of C-shaped canal system in mandibular first and second molars in a Saudi population assessed via cone beam computed tomography: A retrospective study. Clinical Oral Investigations. Jan 2019;**23**(1):107-112

[61] Pawar AM, Pawar M, Kfir A, Singh S, Salve P, Thakur B, et al. Root canal morphology and variations in mandibular second molar teeth of an Indian population: An in vivo cone-beam computed tomography analysis. Clinical Oral Investigations. 2017;**21**(9):2801-2809

[62] Kim SY, Kim BS, Kim Y. Mandibular second molar root canal morphology and variants in a Korean subpopulation. International Endodontic Journal. 2016;**49**(2):136-144

[63] Silva EJ, Nejaim Y, Silva AV, Haiter-Neto F, Cohenca N. Evaluation of root canal configuration of mandibular molars in a Brazilian population by using cone-beam computed tomography: An in vivo study. Journal of Endodontia. 2013;**39**:849-852

[64] Ladeira DB, Cruz AD, Freitas DQ, Almeida SM. Prevalence of C-shaped root canal in a Brazilian subpopulation: A cone-beam computed tomography analysis. Brazilian Oral Research. 2014;**28**:39-45

[65] Scarfe WC, Levin MD, Gane D, Farman AG. Use of cone beam computed tomography in endodontics. International Journal of Dentistry. 2010;**2009**:634567

[66] Kim Y, Perinpanayagam H, Lee JK, et al. Comparison of mandibular first molar mesial root canal morphology

using microcomputed tomography and clearing technique. Acta Odontologica Scandinavica. 2015;**73**:427-432

[67] Rogazkyn D, Metzger Z, Solomonov M. The prevalence and asymmetry of C-shaped root canals in second mandibular molars in a European-Russian population: A cone-beam computed tomography study in vivo. International Journal of Endodontic Rehabilitation. 2016;**2**:12-16

[68] Neelakantan P, Subbarao C, Subbarao CV, Ravindranath M. Root and canal morphology of mandibular second molars in an Indian population. Journal of Endodontia. 2010;**36**(8):1319-1322. DOI: 10.1016/j.joen.2010.04.001

[69] Ceperuelo D, Lozano M, Duran-Sindreu F, Mercade M. Root canal morphology of chalcolithic and early bronze age human populations of el mirador cave (sierra de atapuerca, Spain). The Anatomical Record. 2014;**297**:2342-2348

[70] Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. International Endodontic Journal. 2002;**35**:56-62

[71] Kuzekanani M, Haghani J, Nosrati H. Root and canal morphology of mandibular third molars in an Iranian population. Journal of Dental Research, Dental Clinics, Dental Prospects. 2012;**6**:85-88

**147**

**Chapter 9**

**Abstract**

understandable.

**1. Introduction**

treatment [1].

**2. Maxillary incisor teeth**

Anatomy

*Esra Pamukcu Guven*

Root Canal Morphology and

**Keywords:** tooth morphology, root canal morphology, dental anatomy,

technologic devices, illumination and magnification systems

Japanese population were found in 46% of the specimens.

Success in root canal treatment depends on the proper application of all procedures of root canal treatment. This wholistic approach includes leakproof crown restoration, following ideal instrumentation, irrigation and hermetic obturation. Therefore, the first step of root canal treatment begins with understanding the tooth morphology in detail. The teeth vary according to their localization at the jaws and the gender and race of people. Detection of the extra canals, canal curvatures, isthmuses and lateral and accessory canals plays an important role in the success of root canal treatment. With all this, the academic knowledge and proficiency of the dentist and/or endodontist enable tooth morphology to be more clearly

Understanding the anatomy of the root canal system is essential for a successful root canal treatment. Complexity of root canals depends on reasons such as ethnicity, gender, age, the existence of lateral/accessory canals, isthmuses, the location of the teeth at the jaws and anomalies of the teeth (dens invaginatus, dens evaginatus, fusion, gemination, dens in dente). Besides all of these, some physiological alterations occur in enamel and dentin with age. Mineralization of dentin results in calcification of dentinal tubules; thus, dentin becomes sclerotic. Several difficulties occur during root canal treatment in such cases. The utilization of novel technologic equipments for magnification and lightning of the root canal system like dental microscope, loupe, radiographic visualization systems and cone beam computed tomography (CBCT) in dentistry enlightens endodontic

Maxillary central teeth have one root and one main canal [2]. Rarely, at 6% rate one canal of maxillary central teeth is divided into two parts at the apical foramina which can be classified as Vertucci type V (**Figure 1**). Apical root canal anatomy should be regarded because of its main effect on the success of root canal treatment (**Figure 2**). In the study of Adorno et al. [3], accessory canals in the apical 3 mm at

#### **Chapter 9**
