Dental root abnormalities

Abstract

Introduction: The tooth is the result of a long process of cellular changes occurring in the ecto-mesodermic tissues of the stomodeum. Theoretically, but not practically, the tooth can be morphologically variable, considering its ecto-mesodermic origin and its appearance in an area of border and continuity of the ectoderm into the endordem. The atypical tooth morphology can refer to the crown portion and/or root portion and to its implantation in the alveolar bone. Dental anomalies are congenital abnormalities that occur in the growth and development of the dental system, which leads to tooth deviations from a normal type in terms of shape, number, location and implant position. Root morphology, especially the endodontic configuration of root structures may be crucial in the endodontic treatment and the maintenance of the tooth in the arch. Root and canal configuration can be the cause of endodontic treatment failure. Detection failure of root canals or their ramifications in the apical third is one of the most common complications in the endodontic treatment. Considering the above mentioned, the raised issued is not fully elucidated and requires some research. Purpose: to study the root anomalies of various groups of permanent teeth and the causes that can lead to those. Objectives: • The study of bibliographic sources on the current topic; • Analysis of some radiological clichés of permanent teeth roots with a normal anatomical structure and with developing anomalies. • A clinical study based on extracted permanent tooth. Materials and methods: While fulfilling the outlined objectives I researched 31 foreign and domestic literary sources, I analyzed 56 radiological clichés with various dental anomalies, and I selected 47 permanent teeth with anomalies of the dental roots from the 215, extracted on different reasons, teeth. The radiological clichés were analyzed using X-ray fluoroscopy. The 47 teeth were studied macroscopic and with a magnifier capable of enlarging the image 10 times. Results: The data we obtained shows that the radiological examination complements the clinical one, bringing useful information; especially when the root segment is affected by anomalies. In radiological clichés analysis I found that dental roots may show various deviations from normal that take different forms. We have cases like: mono-radicular root duplication of the incisors and premolars; incisors accessory roots; accessory roots of upper and lower premolars; taurodontism; dilaceration; flexia; short roots, thin roots, or concrescent roots; tooth in a tooth. Anatomical study of the extracted teeth provided us a number of deviations from their normal structure. The following were detected: a number of supernumerary roots in the incisors, premolars and molars group; root flexia; convergence. A special interest presented the tooth.germination where a dental germ is divided causing crown duplication with a small root. Conclusions: After analyzing the literature sources, the x-rays and the extracted teeth, we can indicate that root anomalies are encountered rarely. These are usually caused by hereditary or genetic defects or spontaneous genetic mutations. Anomalies can also have environmental and traumatic causes. The result of our research confirms again that the x-ray examination brings very useful information that becomes indispensable in more difficult cases where anomalies are involved. We also found various clinical forms of root anomalies, in the extracted teeth, which probably lead the doctors to remove them. Identification of root abnormalities and of the specific form, are very important in terms of endodontic treatment because when root anomalies probability is not taken into account the risk of various incidents and aggravations during the endodontic treatment rises which can lead to a final failure.