Estudo morfológico da anatomia do sistema de canais radiculares de molares superiores decíduos utilizando a microtomografia computadorizada

Abstract

Early childhood caries is a highly prevalent condition that can compromise the eruption and morphology of permanent teeth. When pulpal involvement occurs, the absence of adequate endodontic treatment results in premature tooth loss and alterations in the eruption sequence. Therefore, to avoid the premature loss of the primary tooth, endodontic treatment is essential. Furthermore, for this to be carried out properly, knowledge of internal and external anatomy is a key piece for the success of the treatment. Therefore, this study aimed to analyze the morphology of the root canal system of primary maxillary molars using micro-computed tomography (micro-CT). Twenty-eight primary teeth were evaluated, totaling the analysis of 95 roots. The specimens were scanned by micro-CT and analyzed slice by slice using CTAn and CTVol software. The assessment included the classification of root canal configuration and isthmuses, as well as the presence of apical deltas, apical foramina, accessory canals, and radicular secondary canals. The data were analyzed using the Kruskal- Wallis and chi-square tests (p < 0.05). The results indicate a generally low occurrence of anatomical variations, with the apical delta being the least observed structure. Secondary canals were the most frequent variation, occurring mainly in the mesiobuccal (57.1%) and distobuccal (53.6%) roots. A statistically significant difference was found only in the distribution of isthmuses, with a predominance of Type III in the buccal roots and absence of isthmuses in 75% of the palatal roots. It is concluded that the internal anatomical complexity of these teeth is greater in the mesiobuccal and distobuccal roots, especially in the apical third. Micro-computed tomography is an essential high-precision tool for the three-dimensional mapping of these structures, providing crucial clinical support for the diagnosis, planning, and predictability of endodontic treatment in primary dentition.