Documentos de Académico
Documentos de Profesional
Documentos de Cultura
2 PRE MOLAR
BY
O.R.GANESH MURTHI
M.Sc.D ENDO
OUT LINE
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INTRODUCTION
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EXTERNAL ANATOMY
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INTERNAL ANATOMY
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VARIATIONS
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ANOMALIES
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ENDODONTIC
CORRELATION
INTRODUCTION
§ The term premolar is used to
designate any tooth in the permanent
NECROTIC PULP
ADULT RCT
IRREVERSIBLE
PULPITIS
YOUNG
Irreversible Pulpit's
Reversible Pulpit's Necrotic Pulp
Occlusal plane is
perpendicular to tooth Axis
Mandibular 2nd premolar
2 lingual cusps (most
commonly)
2/3
• Mesiolingual – major,
2/3 MD diameter,
same height as Buccal
• Distolingual – minor
Lingual groove
Mandibular 2nd premolar
Mesial aspect
Triangular ridges of Buccal
Distal aspect
Both lingual cusps are
seen
Mandibular 2nd premolar
Occlusal aspect
Square profile
Mesial & Lingual profiles are
parallel
More than half of Buccal
surface is visible
Buccal ridge is less prominent
than that of mandibular 1st
premolar
Mesial & Distal Marginal
ridges are equal in length
Mandibular 2nd premolar
Occlusal view
M
Mesial & Distal D
triangular fossae
each contains
• A pit
• Mesiobuccal &
Distobuccal grooves
Mandibular 2nd premolar
Occlusal view
Grooves (Y shape meet at the
central pit)
• Mesial groove separates
Buccal & Mesiolingual triangular
ridges – runs obliquely
• Lingual groove separates B
lingual cusps DL
ML
v
Mesiodistal width - narrow
v
Buccolingual width - wide
v
Lingual horn is more prominent
under a well developed lingual
cusp
v
30 lingual tilt
v
Cross section – ovoid with greater
Mandibular 2nd premolar
Mandibular 2nd premolar
ROOTS AND ROOT CANALS
Distal curve – 40 %
Straight – 39 %
Buccal curve – 11 %
Lingual curve – 10 %
ROOTS AND ROOT CANALS
DIVISION IS BUCCAL
AND LINGUAL
PORTION OF THE h
ACCESSORY CANALS
Mostly found in the
apical third Lateral
canals may be found in
44.3% cases Usually a
good biomechanics
preparation cleanses
the canal well and is
filled with the sealer
during Obturation.
The ability to cleanse
and seal these canals
have an impact on the
prognosis
Mandibular 2nd premolar
Note :
Note:
If a straight-on preoperative
radiograph of a Mandibular 2
premolar shows the pulp canal
disappearing in mid-root, this is
an important indication that two
canals are present.
Mandibular 2nd premolar
The mandibular second premolar is
similar to the first premolar, with the
following differences:
Ø
The lingual pulp horn usually is
larger
Ø
The root and root canal are more
Ø
The pulp chamber is wider
THE ACCESS CAVITY
The access cavity form for the Mandibular
second premolar varies in at least two
ways in its external anatomy.
LEVEL
Midroot level AND
: the APICAL
canal
continues to be long ovoid
and requires perimeter
filing
Apical third level: the
canals, generally round,
are shaped into round,
tapered preparations.
Preparation terminates at
the cementodentinal
junction, 0.5 to 1.0 mm
from the radiographic
apex.
MANDIBULAR 2 PREMOLAR TEETH
ERRORS IN CAVITY PREPARATION
PERFORATION
INCOMPLETE
BIFURCATION
Of a canal
completely missed,
caused by failure to
adequately explore
the canal with a
curved instrument
MANDIBULAR 2 PREMOLAR TEETH
ERRORS IN CAVITY PREPARATION
APICAL PERFORATION
Of an invitingly straight
conical canal. Failure to
establish the exact
length of the tooth leads
to trephination of the
foramen
MANDIBULAR 2 PREMOLAR TEETH
ERRORS IN CAVITY PREPARATION
PERFORATION
Ø Dens evaginatus
Ø Gemination
Ø Dilaceration
DENS INVAGINATUS
v Dens invaginatus is a malformation
of teeth probably resulting from an
infolding of the dental papilla during
tooth development.
v Affected teeth show a deep infolding
of enamel and dentine.
v Occurs before calcification of the
teeth.
v Also known as dens in dente
EATMENT OF DENS INVAGINAT
• The treatment modalities depend on
the degree of complexity of its
anatomy.
• They include nonsurgical endodontic
treatment, endodontic surgery and
extraction.
• In cases in which there is an
immature apex, calcium hydroxide is
used to stimulate apexification
DENS
EVAGINATUS
• Dens evaginatus is a
developmental anomaly that
manifests as a tubercle
emerging from the surface of
the affected tooth.
• It occurs most frequently in the
premolars.
• Higher prevalence among people
of Mongoloid origin.
DENS EVAGINATUS
Clinical importance
• Fracture or wear of the tubercle
could lead to pulp necrosis before
root formation is complete.
• Various prophylactic treatments like
selective grinding, application of
resin, restorations and partial
Pulpotomy can be done.
• If there is complete pulpal necrosis in
an immature tooth, MTA can be used
in the apex followed by endodontic
treatment.
Mandibular second
premolar with
three root canals
Report of a case
A 20- year-old male with non
contributory medical history was
referred to the clinics of the SaudiBoard
in Advanced Restorative at the Faculty
of Dentistry, for evaluation of root canal
therapy of a mandibular 2 premolar.