Evaluation of the internal anatomy of paramolar tubercles using cone-beam computed tomography.

PURPOSE: To evaluate the internal anatomy of paramolar tubercles (PTs) on molars, determine the existence of root canals in these structures that either communicate with or are isolated from the main root canals of teeth, and analyze the prevalence of root fusion and a C-shaped canal configuration using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Twenty-six molars with PTs from the study group and 664 molars without PTs from the control group were evaluated using CBCT. The locations and sizes of tubercles were noted. The existence of root canals in PTs was detected. All teeth were evaluated according to the presence or absence of root fusion and a C-shaped canal configuration. Statistical analyses were performed with Pearson Chi square and Fisher's exact tests (p < 0.05). RESULTS: Eleven (42.3%) PTs with their own canals communicated with the main root canals of teeth, and 10 of 11 PTs (90.9%) were larger than 4 mm in size. No PT possessed its own canal independent from the other canals. Teeth with PTs tended to have more root fusions than teeth without PTs. A statistically significant correlation was observed between PTs and the C-shaped canal configuration (p < 0.01). Maxillary second molars with PTs were the major teeth showing variations in the internal morphology. CONCLUSIONS: PTs are an uncommon anatomical variation that is specific to the coronal and radicular morphology. Therefore, clinicians should be aware of its unpredictable and complex internal anatomy, particularly in cases requiring endodontic treatment. CBCT is recommended for teeth with PTs, particularly maxillary second molars, to improve the prognosis of the teeth.

Human identification using dental techniques: A case report.

Dental identification of skeletal remains frequently relies on data comparison. Comparative dental identification is used to establish with a high degree of certainty that the remains of a corpse and a person represented by ante-mortem dental records are the same individual. There is no minimum number of concordant points necessary to perform a positive identification; rather, each case is unique and should be treated as such. In this paper, we present a report of a case in which positive identification was made by a paramolar tubercle in both upper first deciduous molars.

Parastyle cusp: A rare morphologic variant of maxillary second molars.

Human jaws and teeth show a high diversity in the morphology, which varies from individual to individual. The variation in the morphologic feature is of great importance in the forensic field for identification. A tubercle or an accessory cusp is rare but is usually seen in the mandibular molar buccal aspect. From a forensic odontologist's point of view, the features though rare and unusual are useful for identification of the victim as well as criminal. The article presents three cases showing this rarest morphologic variation, i.e., the presence of a parastyle on a permanent maxillary second molar.

Mandibular second molar exhibiting a unique "Y-" and "J-" "shaped" root canal anatomy diagnosed using cone-beam computed tomographic scanning: A case report.

This article aims to report a unique case with aberrant root canal anatomy exhibiting "Y-" and "J"-shaped canal pattern in a mandibular second molar. Anatomic complexities may pose challenges for endodontic treatment. Before performing endodontic treatment, the clinician should be aware of the internal anatomy of the tooth being treated and should recognize anatomic aberrations if present. Presence of unusual anatomy may call for modifications in treatment planning. This report describes in detail about a mandibular second molar tooth associated with two paramolar tubercles having a peculiar "Y-" and "J-"shaped canal anatomy detected with the aid of cone beam computed tomography, which has never been reported in the dental literature. The proposed treatment protocol for the endodontic management of the same has also been discussed.

Endodontic management of maxillary second molars fused with paramolar tubercles diagnosed by cone beam computed tomography - two case reports.

The main objective of nonsurgical endodontic treatment is to eliminate micro-organisms from the root canal system. Adequate knowledge of the root canal morphology and its complexities is essential to render successful endodontic treatment. Variations in tooth form and morphology may be found in the form of anomalous cusps in the crown region or additional roots. In permanent molars, changes in the crown morphology may occur either in the form of an additional tooth (paramolar) or supernumerary cusp termed as "paramolar tubercle".

Paramolar tubercle: A diversity in canal configuration identified with the aid of spiral computed tomography.

The objective of this article is to increase our understanding of the root canal system of the anomalous structures like paramolar tubercles. The knowledge of the internal anatomy of the paramolar tubercles is very important as they influence the treatment modalities and associated problems in many dental disciplines. This case report investigates the anatomical and morphological characteristics of a rare case of two well-developed lobulated cusps occurring on the buccal surface of maxillary right second molar with the aid of spiral computed tomography. Unlike to previous reports, in our case the tubercles had their own pulp chamber with its root fused to the mesiobuccal and distobuccal roots of maxillary right second molar, while its canal remained independent from the main root canals.

Paramolar - A supernumerary molar: A case report and an overview.

Paramolar is a supernumerary molar usually small and rudimentary, most commonly situated buccally or palatally to one of the maxillary molars. Paramolar is a developmental anomaly and has been argued to arise from a combination of genetic and environmental factors. Reports of this entity are rarely found in the dental literature. This article presents a case report of an unusual occurrence of a paramolar in the maxilla in otherwise a healthy individual. In addition, literature review, prevalence, classification, etiology, complications, diagnosis, and therapeutic strategies that may be adopted when supernumeraries occurs have been discussed.

Examination of paramolar tubercles in Turkish population using cone beam computed tomography / Estudio de los tuberculos paramolares en una población turca mediante tomografía computarizada de haz cónico

SUMMARY: Paramolar tubercle (PT) is an additional cusp occuring on buccal surface of both upper and lower permanent molars. PT is also known as parastyle when tubercle is present in upper molars, as protostylid when tubercle is present in lower molars. The aim of this study was to evaluate prevalence of PTs in Turkish population with cone beam computed tomography (CBCT). Presence of PT in molar teeth were evaluated retrospectively using CBCT images of 210 patients (102 male, 108 female) between 18-77 years old. A total of 909 teeth were analyzed. Because of various reasons some teeth were excluded and final analyze was done with 653 teeth. Prevalence of PT was found as 2.76 % (18 out of 653). Highest frequency of PT was detected 5 in #27, 4 in #17, 2 in #48 among all molar teeth respectively. In two cases; 2 PTs were on the same tooth, bilateral PT was found only in one case. PT was undetected on upper first molars. Prevalence of PTs on permanent molars is a rare phenomenon in the studied population. Use of CBCT in such anatomic variations will provide valuable and detailed information during treatment modalities. Since this pilot study represents Turkish subpopulation, comprehensive studies with increased number of cases should be undertaken to clarify the prevalence of paramolars in Turkish population. Advanced imaging techniques like CBCT will be more helpful in understanding and detecting exact morphological and anatomical variations of PTs during treatment modalities.

RESUMEN: El tubérculo paramolar (TP) es una cúspide adicional que está en la superficie vestibular de los molares permanentes superiores e inferiores. El objetivo de este estudio fue evaluar la predisposición de TP en la población turca con tomografía computarizada de haz cónico (TCHC). Presencia de TP en dientes molares se evaluaron retrospectivamente utilizando imágenes de tomografia de 210 pacientes (102 hombres, 108 mujeres) entre 18-77 años de edad. Se analizó un total de 909 dientes. Por varias razones, algunos dientes fueron excluídos y el análisis final se realizó con 653 dientes. Prevalencia de PTP se encontró en el 2,76 % (18 dientes de 653). La frecuencia más alta de TP se detectó: 5 en # 27, 4 en # 17, 2 en # 48, entre todos los dientes molares, respectivamente. En dos casos, 2 de los TP fueron observados en el mismo diente; TP bilateral sólo se encontró en un caso. El TP no fue detectado en los primeros molares superiores. La prevalencia de TP en los molares permanentes es un fenómeno poco frecuente en la población estudiada. El uso de la TCHC en tales variaciones anatómicas, proporcionará información valiosa y detallada para definir la aplicación de diferentes modalidades de tratamiento. Dado que este estudio piloto representa a una subpoblación turca, estudios exhaustivos con un mayor número de casos deben llevarse a cabo para determinar la prevalencia en la población turca total. Técnicas avanzadas de imagen como TCHC serán más útiles para detectar variaciones morfológicas y anatómicas exactas de TP durante diversas modalidades de tratamiento.

Tubérculo paramolar en un segundo premolar superior izquierdo: reporte de un caso / Paramolar tubercle on second upper left premolar: a case report

En el presente artículo se presenta el reporte de un caso en el cual se registra la presencia de un tubérculo paramolar en la superficie vestibular del segundo premolar superior izquierdo (diente 25) La descripción de este rasgo morfológico dental coronal se realiza a partir de los conocimientos científicos que proporciona la antropología dental, con el fin de comprender el comportamiento de su frecuencia y variabilidad y de esta forma, basados en la evidencia, analizar su importancia y manejo dentro de los contextos antropológico, odontológico y forense.

This paper is a case report description of the paramolar tubercle presence on the buccal surface of left upper second premolar (25 tooth). The description was done under the dental anthropology point of view and this tooth mark may be useful to classify and identify human populations.