Morphology of the Physiological Foramen: II. Maxillary and Mandibular Premolars

Thomas Gerhard Wolf; Andrea Lisa Waber; Benjamín Briseño Marroquín

doi:10.1016/j.joen.2024.03.003

Morphology of the Physiological Foramen: II. Maxillary and Mandibular Premolars

J Endod. 2024 Mar 16:S0099-2399(24)00162-6. doi: 10.1016/j.joen.2024.03.003. Online ahead of print.

Authors

Thomas Gerhard Wolf¹, Andrea Lisa Waber², Benjamín Briseño Marroquín³

Affiliations

¹ Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Germany. Electronic address: thomas.wolf@unibe.ch.
² Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland.
³ Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Germany.

PMID: 38493831
DOI: 10.1016/j.joen.2024.03.003

Abstract

Introduction: Information concerning the anatomy of the physiological foramen is still limited. The aim of this study was to investigate the distance between the physiological and anatomic apex, the shape and diameter of the physiological foramen in maxillary (Mx) and mandibular premolars (Mn).

Methods: The anatomy of the apex of 229 maxillary (first: MxP1; second: MxP2) and 221 mandibular premolars (first: MnP1; second: MnP2) from a mixed Swiss-German population was investigated by means of microcomputed tomography and 3-dimensional software imaging.

Results: The following results were obtained in the presence of a main physiological foramen. 1. The distance between the physiological and anatomic foramen was 0.29-0.99 mm (MxP1), 0.21-1.03 mm (MxP2), 0.13-0.8 (MnP1), and 0.15-1.41 (MnP2). 2. The mean narrow and wide diameters of the physiological foramen were 0.19-0.33 mm (MxP1), 0.25-0.42 mm (MxP2), 0.28-0.37 (MnP1), and 0.28-0.40 (MnP2). 3. The most common physiological foramen shape was oval (66.7% MxP1, 89.7% MxP2, 91.8% MnP1, 64.4% MnP2).

Conclusion: Considering the recommended preparation sizes based on a size corresponding to the friction, that is at the narrowest point in the area of the apical constriction (physiological foramen), and within the limitations of this ex vivo microcomputed tomography study, a final preparation size could be chosen when considering the pertaining morphologic considerations; yet, to a minimum ISO 30 size.

Keywords: Anatomic apex; apical constriction; final apical file; maxillary and mandibular premolars; micro-CT; morphology; physiological foramen.