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by
JAMES L . GUTMANN, D.D.S.*
INTIMATE
anatomical relation of the pulp to
periodontal tissue via accessory canals has been established by many investigators. In pathological situations, interactions between the two tissues can occur
via toxic products and/or inflammatory extensions,
with resultant concomitant pulpal-periodontal breakdown. Pulpal-periodontal interactions have been observed clinically in the furcation region of maxillary
and mandibular permanent molars (Figs. 1 A and B )
following pulpal injury. Although a review of the
literature presents strong documentation for the presence of accessory canals in the furcation region of
molars and their potential involvement as pathways
for the transmission of disease processes, an accurate
anatomical prevalence of accessory canals is lacking.
The purpose of this study is to determine the prevalence, location, and patency of accessory canals in the
furcation region of permament molars.
23
REVIEW
18
21
22
1-15
17
10
2 0
T H E
LITERATURE
24
MATERIALS
A N D
METHODS
19
21
with
22
J . Periodontol.
January, 1978
Gutmann
F I G U R E 1A and B . Destruction
of bone in the
region of mandibular molars due to pulpal disease.
furcation
in tap water and the crowns were reduced circumferentially to eliminate any irregularities, i.e. grooves,
ridges, etc. The pulp chamber was entered occlusally
according to standard endodontic techniques and the
gross tissue was debrided with X X X X F and X X X F
broaches.*
The teeth were stored in a 3% hydrogen peroxide
solution for 3 weeks and the solution was changed
every 3 to 4 days. Hibbard and Ireland determined
that decalcification does not occur in the presence of
3 % H 0 . Likewise, hydrogen peroxide does not dissolve organic debris but destroys the tissue attachment
to the tooth allowing for easy tissue debridement.
The teeth were rinsed in tap water for 20 minutes
and placed in 9 5 % alcohol for 24 hours after which
they were air dried. A 1-inch section of x 6
rubber latex tubingt was placed around the crown of
each tooth and was secured with 0.18 stainless steel
wire.t R e d sticky wax was applied to the apical onethird of each root to seal the apical foramen. (Fig. 2)
The rubber tubing with attached tooth was secured to
a glass tube located in a N o . 7 rubber stopper designed
to fit a 500-ml flask which was attached to a vacuum
25
*
t
t
Volume 49
Number 1
Accessory Canals 23
DISCUSSION
27
Region
Mandibular
Maxillary
Total
51
15 (29.4%)
51
14 (27.4%)
102
29 (28.4%)
21
22
43
F I G U R E 5. Pin-point cemental staining located in the
tion" only (arrows).
"furca-
only
Mandibular
Maxillary
Total
51
13* ( 2 5 . 5 % )
51
12* ( 2 3 . 5 % )
102
25 (24.5%)
14t
16*
30
Mandibular
Maxillary
Total
51
6(11.8%)
51
4 (7.8%)
102
10(10.2%)
7*
6t
13
* One tooth had two accessory canals on the lateral root surface,
t T w o teeth had two accessory canals on the lateral root surface.
J. Periodontol.
January, 1978
Gutmann
24
31
(arrow)
22
12
23
29
Volume 49
Number 1
Accessory Canals 25
32
13,14,33,34
11
SUMMARY
REFERENCES
J. Periodontol.
January, 1978
Gutmann
26
35: 9 5 7 , 1 9 5 6 .
250,1957.
Announcements
THE
L. D. PANKEY
INSTITUTE
A p r i l 6, 7, 1978
FACULTY: D R . A L L A N
S C H L O S S B E R G , D . M . D . , M . S . Associate P r o -
This course will provide an update for both the generalist and the
specialist i n the fields of Endodontics and Periodontics. Emphasis
will be placed on current concepts of diagnosis, treatment planning
and clinical therapy.