Narrative literature review on the complexity of the internal anatomy of root canals

Abstract

The intricate and highly variable nature of the internal anatomy of root canals poses significant challenges for effective endodontic treatments. The aim of the study was to interpret the complexity of the internal anatomy of root canals through a narrative literature review. This study adopted an exploratory methodology and was characterized by its observational and descriptive nature, analyzing information from a cross-sectional and retrospective perspective. An exhaustive evaluation of 25 articles was conducted on PubMed, Google Scholar, and Elsevier through ScienceDirect, from 2016 to 2023. This study revealed that a deep understanding of the internal root anatomy and its variations is essential for the success of endodontic treatments, highlighting the importance of advanced diagnostic techniques, such as Cone Beam Computed Tomography (CBCT), for identifying anomalies. It was found that anatomical variations, including C-shaped canals, lateral canals, and apical deltas, are more prevalent in posterior teeth. Moreover, anterior lower teeth rarely exhibit more than one root, with Vertucci type I classification predominating in their internal anatomy, which implies less complexity compared to posterior teeth. It concludes that success in endodontics critically depends on detailed knowledge of the internal root anatomy. The findings emphasize the need to apply precise diagnostic techniques and adapt treatment strategies to the specific anatomical complexity of each tooth, especially in those with more complex root configurations