Advantages and Applications of a New System for Classifying Roots and Canal Systems in Research and Clinical Practice

Abstract

Objective: A new coding system for classifying the roots, main and accessory canals as well as developmental anomalies has been introduced recently. This paper discusses the advantages and potential application of the new system in research and clinical practice. Methods: A comprehensive analysis was undertaken on the most common, existing classification for root canal morphology. The advantages and potential applications of a new system for classifying roots and canal systems in research and clinical practice are discussed. Results:The analysis demonstrates deficiencies of the existing classification including lack of information on the number of roots, pulp chamber outline, lack of clarity in multi-rooted teeth, inability to define complex root canal configurations. The new coding system addresses the root and canal morphology in an accurate and systematic manner to provide detailed information of the tooth, root and canal anatomical features. Conclusion: With current advances in endodontic research and practice and the increasing body of knowledge on root and canal morphology, the deficiencies of the existing system used for classifying root canal morphology have become more apparent. The new system for classifying root, main and accessory canal morphology as well as teeth with anomalies has the potential to be used in research, clinical practice and education to accurately reflect the real anatomy of a tooth. Keywords: Anatomy, canal configuration, classification, morphology, root, root canal INTRODUCTIONEffective root canal treatment requires thorough knowledge of root and canal morphology (1). Tooth anatomy is complex and several systems are available for classifying the variations that occur (2-4). The system proposed by Vertucci et al. (3) together with supplemental configuration types (5-8) has been the most commonly used classification.With an increasing range of anatomical complexities being reported and the deficiencies of the existing systems becoming more apparent, new systems for classifying root, root canal and accessory canal morphology have been proposed, which provide detailed information on tooth notation, number of roots, root canal configuration and accessory canal morphology including teeth with anomalies (9-11). The purpose of this paper is to discuss the advantages and potential applications of these new systems in research and clinical practice. Shortcomings of the present system to categorise canal anatomy and advantages of the new systemDefining the number of roots Maxillary premolars: Vertucci (12) categorized the root canal systems of human teeth into eight types (Figure 1). However, for maxillary premolars, whether the canals were within one, ABSTRACT HIGHLIGHTS• With current advances in endodontics and increasing body of knowledge, the deficiencies of the existing system used for classifying root canal morphology have become more apparent.• The new coding system provides detailed information on the tooth, root, main and accessory canal morphology as well as teeth with anomalies.•...

Root and canal configurations of maxillary premolars in a South African subpopulation using cone beam computed tomography and two classification systems

“…In three rooted-teeth, if fusion was present along the entire root length or partial fusion with common canals, the tooth was classified according to the criteria set out by Zhang et al [19], including the modifications suggested by Ahmed and Dummer [20]. Fused roots with communications were indicated using two slashes (//) [20].…”

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

“…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.…”

The abilities of three Nickel–Titanium mechanized systems to negotiate and shape MB2 canals in extracted maxillary first molars—a Micro‐Computed Tomographic study

“…• The authors mentioned that the study samples were maxillary first molars; therefore, it is more appropriate to use an abbreviation such as MxFM (for Maxillary First Molars) rather than "TN", which denotes to the Tooth Number (Ahmed et al 2017, Ahmed & Dummer 2018).…”