|Year : 2015 | Volume
| Issue : 2 | Page : 98
A paradigm evolution shift in the endodontic map
Hany Mohamed Aly Ahmed
Department of Restorative Dentistry, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
|Date of Web Publication||27-Mar-2015|
Dr. Hany Mohamed Aly Ahmed
Department of Restorative Dentistry, School of Dental Sciences, Universiti Sains Malaysia, 16150, Kubang Kerian, Kelantan
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Ahmed HM. A paradigm evolution shift in the endodontic map. Eur J Gen Dent 2015;4:98
A "paradigm evolution shift" could refer to current advances in diagnostic technology in endodontics. The last decade has shown numerous reports on the identification of external and internal anatomical radicular variations in the human dentition. Apparently, a "reconsideration" of our endodontic map for root and root canal morphology is appropriate. 
Many decades ago, the occurrence of three-rooted mandibular molars has been reported in some populations groups. However, with the aid of advanced diagnostic modalities such as cone beam computed tomography (CBCT), this anatomical variation is currently becoming a common normal morphologic variant in Asian traits, with prevalence reaching >30%. ,
Current literature reports similar observations in the occasion of middle mesial (MM) canals in mandibular molars. For many years, the prevalence of MM root canals in mandibular molars has been reported as a rare or a not uncommon variant ranging from <1% to 19%.  However, in 2015, the prevalence of MM canals in clinical settings is higher than previously reported , and reaches up to 46.2%.  Clearly, the application of operating microscopy together with an "appropriate troughing approach" has a valid impact on locating negotiable MM canal orifices.
In recent years, micro-computed tomography (micro-CT) has gained increasing significance in the study of root canal morphology in endodontics. Micro-CT studies continue to demonstrate high levels of complexity of the root canal system, and many root canal configurations, encased in roots such as mesiobuccal roots of maxillary molars, distal roots of mandibular molars and single-rooted mandibular anteriors are described as "nonclassifiable." ,,
Now, the following questions need to be addressed. Does the future hold a shift in the prevalence of additional root canal types in the human dentition?. Can advanced experimental diagnostic techniques together with current advances in endodontic armamentarium applied in our clinics (including CBCT, operating microscopy, and thorough exploration) change our perspectives toward "new," "rare," "not uncommon" and "common" anatomical variations in different populations?. These questions cannot be answered without an intimate collaboration between researchers and clinicians. ,
| References|| |
Ahmed HM. The foremost challenge in endodontics and pediatric dentistry. Aperito J Oral Health Dent 2015;1:103.
De Pablo OV, Estevez R, Péix Sánchez M, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: A systematic review. J Endod 2010;36:1919-31.
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 canals. J Endod 2013;39:1516-21.
Ahmed HM, Luddin N. Accessory mesial roots and root canals in mandibular molar teeth: Case reports, SEM analysis and literature review. ENDO Endod Prac Today 2012;6:195-205.
Azim AA, Deutsch AS, Solomon CS. Prevalence of middle mesial canals in mandibular molars after guided troughing under high magnification: An In Vivo
investigation. J Endod 2015;41:164-8.
Nosrat A, Deschenes RJ, Tordik PA, Hicks ML, Fouad AF. Middle mesial canals in mandibular molars: Incidence and related factors. J Endod 2015;41:28-32.
Verma P, Love RM. A Micro CT study of the mesiobuccal root canal morphology of the maxillary first molar tooth. Int Endod J 2011;44:210-7.
Leoni GB, Versiani MA, Pécora JD, Damião de Sousa-Neto M. Micro-computed tomographic analysis of the root canal morphology of mandibular incisors. J Endod 2014;40:710-6.
Filpo-Perez C, Bramante CM, Villas-Boas MH, Húngaro Duarte MA, Versiani MA, Ordinola-Zapata R. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar. J Endod 2015;41:231-6.
Ahmed HM. Anatomical challenges, electronic working length determination and current developments in root canal preparation of primary molar teeth. Int Endod J 2013;46:1011-22.