A new system for classifying tooth, root and canal anomalies

Abstract

Ahmed HMA, Dummer PMH. A new system for classifying tooth, root and canal anomalies. International Endodontic Journal, 51, 389-404, 2018. Understanding the normal anatomical features as well as the more unusual developmental anomalies of teeth, roots and root canals is essential for successful root canal treatment. In addition to various types of root canal configuration and accessory canal morphology, a wide range of developmental tooth, root and canal anomalies exists, including C-shaped canals, dens invaginatus, taurodontism, root fusion, dilacerations and palato-gingival grooves. There is a direct association between developmental anomalies and pulp and periradicular diseases that usually require a multidisciplinary treatment approach to achieve a successful outcome. A number of classifications have categorized tooth, root and canal anomalies; however, several important details are often missed making the classifications less than ideal and potentially confusing. Recently, a new coding system for classifying root, root canal and accessory canal morphology has been introduced. The purpose of this article is to introduce a new system for classifying tooth, root and canal anomalies for use in research, clinical practice and training, which can serve as complementary codes to the recently described system for classifying root, as well as main and accessory canal morphology.

Application of a new system for classifying tooth, root and canal morphology in the primary dentition

“… The morphology of root canals, accessory canals and tooth anomalies in the primary dentition can be classified using the system of Ahmed et al . (), and Ahmed & Dummer , in a similar way to the permanent dentition. For simplicity, the stage of physiologic root resorption is not considered when classifying primary teeth using the new system. Physiologic root resorption and the presence of a permanent successor close to the roots of primary teeth are challenges for accurate interpretation of accessory canals and several anomalies especially in clinical settings. …”

“…Similar to the permanent dentition, the abbreviation of an anomaly (A) is added between brackets before the tooth number (TN) that is (A)TN (Ahmed & Dummer ,b). For instance, (DE) 1 51 1 describes a dens evaginatus (DE) in a single‐rooted maxillary right primary central incisor tooth with a single canal.…”

“…Root fusion (RF) in three‐rooted teeth is an exception in which all types should be written before the tooth number (TN). (RF 3 ) 3 65 MB 3 DB 2‐1‐2 P 2‐1 describes a three‐rooted tooth 65 having fused DB (canal configuration 2‐1‐2) [Root fusion (RF) type 3 (Ahmed & Dummer ,b)] and P (canal configuration 2‐1) roots whilst the MB (canal configuration 3) is not fused (Ahmed & Dummer ,b) (Fig. ).…”

“…With an increasing range of anatomical complexities being reported and the deficiencies of the existing systems for categorizing canal systems becoming more apparent, a new system for classifying root and canal morphology has been proposed, which provides detailed information on tooth notation, number of roots and root canal configuration in addition to accessory canals and tooth anomalies (Ahmed et al . , , Ahmed & Dummer ,b). The present article discusses the various challenges when describing root and canal morphology in primary teeth and the application of the new system to classify root and canal morphology in the primary dentition.…”

Successful Multidisciplinary Management of an Endodontic‐Periodontal Lesion Associated With a Palato‐Radicular Groove: A Case Report

“…The complexity of the root canal system may even require root resection or intentional extraction/replantation . A Type III PRG may also communicate with an invagination into the canal resulting in increased complexity of the canal system . The clinician should thoroughly discuss with patients alternative treatment options such as tooth extraction/replacement and the benefit‐to‐risk ratio before attempting treatment of a severe PRG.…”