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Table of Contents   
ORIGINAL RESEARCH  
Year : 2013  |  Volume : 24  |  Issue : 6  |  Page : 742-744
Age and sex-related differences of pulp chamber size in mandibular second molars


1 Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun, Turkey
2 Department of Endodontics, Faculty of Dentistry, Bulent Ecevit University, Zonguldak, Turkey
3 Department of Public Health, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

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Date of Submission16-Jun-2010
Date of Decision09-Dec-2010
Date of Acceptance27-Jan-2012
Date of Web Publication20-Feb-2014
 

   Abstract 

Aim: The aim of this study was to compare the size of the pulp chamber in mandibular second molars with the gender and age by means of panoromic radiographs.
Materials and Methods: In this study, 200 panoromic radiographs of patients were randomly selected from the archives of the Faculty of Dentistry of Ondokuz Mayis University. The radiographs of the patients were measured under a stereomicroscope and categorized according to the gender and age.
Results: Statistically differences were found in the mean sizes of pulp chamber between the groups under and above the age of 30 years (P < 0.05). There were significant differences in terms of "the distance between the tip of the lingual cusp to the roof of the pulp chamber", "the distance between the tip of the lingual cusp to the floor of the pulp chamber" and "the distance from the tip of the lingual cusp to the closest point of the furcation" between the male and female genders (P < 0.05).
Conclusion: It is concluded that the pulp chamber can be exposed easily in female patients, because it is less shallow than males. However, the size of pulp chamber reduces after the age of 30 years in both the genders.

Keywords: Age, gender, pulp chamber, size

How to cite this article:
Bodrumlu E, Cicek E, Dundar C. Age and sex-related differences of pulp chamber size in mandibular second molars. Indian J Dent Res 2013;24:742-4

How to cite this URL:
Bodrumlu E, Cicek E, Dundar C. Age and sex-related differences of pulp chamber size in mandibular second molars. Indian J Dent Res [serial online] 2013 [cited 2019 Nov 19];24:742-4. Available from: http://www.ijdr.in/text.asp?2013/24/6/742/127624
Alterations in the size of the pulp chamber make the maintenance of the root canal a difficult objective. Preparation of the cavity for access is one of the most challenging and frustrating aspects of root canal treatment; however, it is the key to successful treatment. [1] Clinicians may make errors, both during the cavity preparation and identification of canal orifices. However, calcification of the pulp chamber can also lead to misjudgments and a perforation of the furcation. [2],[3] Therefore, cavity preparation is dependent on the clinician's tactile perception and knowledge of dental anatomy, which may help in the cavity access design. [4] In addition, differences in the size of the pulp chamber may make locating or negotiating the root canals difficult, thus resulting in inadequate cleaning and shaping of the root canal system and treatment failure.

Several studies have investigated the shape and number of the root canals in addition to the size of the pulp chamber in different races. [5],[6] Dental practice uses panoramic radiography for its imaging needs. Diagnostic imaging helps in the development and implementation of a cohesive and comprehensive treatment plan for the patient. [7] However, using panoramic radiography during diagnosis can help in evaluating the vertical length of the pulp chamber. [8] The size of the pulp chamber and root morphology varied amongst different populations. [6],[9] However, categorization of the size of the pulp chamber in patients of different races of different age and gender had not been studied yet. The aim of this study was to compare the size of the pulp chamber in mandibular second molars with the gender and age in Turkish population by means of the panoromic radiographs.


   Materials and Methods Top


In this study, 200 panoromic radiographs of patients were randomly selected from the Faculty of Dentistry of Ondokuz Mayis University's archives. The radiographs of the patients were categorized according to the gender and age. Diagnostic panoramic radiographs were made with a previously standardized Siemens Orthophos Panoramic machine (Siemens, Munchen, Germany). The radiographs were measured by a digital compass under a stereomicroscope as described by Deutsch and Musikant. [10] Five measurements were taken of each tooth [Figure 1].
Figure 1: The measurement points of A, B, C, D, E on the teeth. Where, measurement A represents the distance from the floor of the pulp chamber to the closest point of the furcation. Measurement B represents the distance from the roof of the pulp chamber to the closest point of the furcation. Measurement C represents the distance between the tip of the lingual cusp to the roof of the pulp chamber. Measurement D represents the distance between the tip of the lingual cusp to the floor of the pulp chamber. Measurement E represents the distance from the tip of the lingual cusp to the closest point of the furcation

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Morphological measurement

  1. Measurement A represents the distance from the floor of the pulp chamber to the closest point of the furcation.
  2. Measurement B represents the distance from the roof of the pulp chamber to the closest point of the furcation.
  3. Measurement C represents the distance between the tip of the lingual cusp to the roof of the pulp chamber.
  4. Measurement D represents the distance between the tip of the lingual cusp to the floor of the pulp chamber.
  5. Measurement E represents the distance from the tip of the lingual cusp to the closest point of the furcation.


Two-way analysis of variance tests were used to determine the interaction between the gender and age on pulp chamber dimensions. All results were considered statistically significant if P < 0.05.


   Results Top


Five direct measures were made for all the teeth

The mean of measurements in terms of the female and male gender, respectively; the distance from the floor of the pulp chamber to the closest point of the furcation 3.37 ± 0.714, 3.55 ± 0.801; the distance from the roof of the pulp chamber to the closest point of the furcation 6.48 ± 1.042, 6.64 ± 1.025; distance between the tip of the lingual cusp to the roof of the pulp chamber 7.27 ± 0.747, 7.57 ± 0.732; the distance between the tip of the lingual cusp to the floor of the pulp chamber 10.44 ± 1.071, 11.00 ± 1.182; the distance from the tip of the lingual cusp to the closest point of the furcation 13.38 ± 1.235, 13.83 ± 1.017. Statistically differences were found in the mean sizes of pulp chamber between the groups under and above the age of 30 years (P < 0.05) [Table 1]. The measurements of the pulp chamber seen as per the gender have been compared in [Table 2]. There were significant differences in terms of "the distance between the tip of the lingual cusp to the roof of the pulp chamber", "the distance between the tip of the lingual cusp to the floor of the pulp chamber" and "the distance from the tip of the lingual cusp to the closest point of the furcation" between the male and female genders (P < 0.05).
Table 1: Mean morphological measurements about the age (mm) as seen in the study


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Table 2: Mean morphological measurements about the gender (mm) as seen in the study


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   Discussion Top


The knowledge of the morphological measurements of the pulp chamber can help a clinician to avoid any accidental pulp exposure or perforation of the furcation of the tooth. Therefore, the size measurement of the pulp chamber has its own significance. In a study of the reproducibility of panoramic radiographs, they were exposed to various clinical conditions. [11] The method for assessment of error for vertical distances in the mandible fell mostly within 3% of total variance. The panoramic radiographs constantly have a 25% vertical magnification ratio, [12] and therefore, are preferred for determining the size of the pulp chamber to standardize the evaluation. [13]

Several studies [9],[10],[14],[15],[16],[17] have evaluated the size of the pulp chamber of the molar teeth by using bitewing, periapical, radiovisiography (RVG) or panoramic radiographs. Sterrett et al. [14] measured the distance from the floor of the pulp chamber to five determined sites on the furcation of the root surfaces, and found it to be in a range of 2.7-3 mm for a mandibular molar using bitewing radiography. Deutsch and Musikant [10] morphologically measured the anatomical landmarks in the pulp chambers of human mandibular molars using RVG and found that the mean distances as: Pulp chamber floor to furcation 2.96 ± 0.78; pulp chamber ceiling to furcation 4.55 ± 0.91; buccal cusp to furcation 10.90 ± 1.21; buccal cusp to pulp chamber floor 7.95 ± 0.79; buccal cusp to pulp chamber ceiling 6.36 ± 0.93; and pulp chamber size 1.57 ± 0.68. Additionally, another study of Deutsch and Musikant [15] reported that the mean distance between the cusp tip and the roof of the pulp chamber in mandibular molars was 6.24 mm. As no other studies had been performed on a similar topic, comparisons of the results could not be done. The mean measurements of the size of pulp chamber in the present study are higher than those found in the study by Deutsch and Musikant. The differences could be accounted for by the magnification of the panoramic radiography and/or the measurement of the mandibular second molars instead of the first molars.

The reduction of the size of pulp chamber with age is an important factor during access cavity preparation. Khojastepour et al. [16] measured the size of the pulp chambers in mandibular first molars in different age groups of 18-25 and 50-65 years, and concluded the following: The mean distance from furcation to cusp tip is 10.41 ± 1.27 10.45 ± 1.03; from the pulp chamber ceiling to cusp tip is 5.41 ± 0.96 5.64 ± 0.84; from the pulp chamber floor to cusp tip is 5.22 ± 0.85 4.78 ± 0.71; from furcation to the pulp chamber floor is 2.89 ± 0.61 3.31 ± 0.43; from the pulp chamber floor to the pulp chamber ceiling is 2.32 ± 0.56 1.65 ± 0.50 mm using bitewing radiographs, respectively. It was reported that the reduction and changes in the size of the pulp chamber occurred in the mandibular first molars with age. Similar results were obtained in our study. It is important to take care of the reduction in the size of the pulp chamber as it can reduce the chances of perforation in the area of the tooth furcation. This may in turn help to minimize the errors during the root canal treatments.

Dentin deposition inside the pulp chamber continues throughout the life of an individual, thus decreasing the chances of accidental perforation of the furcation while preparing the endodontic access. [18] Only few studies till today has compared the sizes of the pulp chambers as per the gender. Chandler et al. [17] reported that the pulp chambers in male mandibular molars were larger; and also there are significant in four aspects of pulp spaces between the genders. They also suggested that the human first molar pulps exhibit sexual dimorphism. Similarly, the sizes of pulp chamber in male mandibular second molars were larger than the female mandibular second molars in our study and significant differences were found. However, in a study by Shaw and Jones, there was no significant difference found in the size of the pulp chambers based on the gender. [19] This situation may be due to the condition of usage of the teeth.


   Conclusion Top


From our study, we could conclude that the pulp chamber can be more readily exposed in female patients as compared to males, as the pulp chamber is shallower in the former. However, the size of pulp chamber reduces after the age of 30 years in both the genders.

 
   References Top

1.Walker RT. Pulp space anatomy and access cavities. In: Pitt Ford TR, editor. Harty's endodontics in clinical practice. 4 th ed. London: Wright; 1997. p. 16-34.  Back to cited text no. 1
    
2.Alhadainy HA. Root perforations: A review of literature. Oral Surg Oral Med Oral Pathol 1994;78:368-74.  Back to cited text no. 2
    
3.Goon WW, Lundergan WP. Redemption of a perforated furcation with a multidisciplinary treatment approach. J Endod 1995;21:576-9.  Back to cited text no. 3
    
4.Christie WH, Thompson GK. The importance of endodontic access in locating maxillary and mandibular molar canals. J Can Dent Assoc 1994;60:527-36.  Back to cited text no. 4
    
5.Melton DC, Krell KV, Fuller MW. Anatomical and Histological features of C-shaped canals in Mandibular second molars. J Endod 1991;17:384-8.  Back to cited text no. 5
    
6.Sperber GH, Moureau JL. Study of the number of roots and canals in Senegalese first permanent mandibular molars. Int Endod J 1998;31:117-22.  Back to cited text no. 6
    
7.Monson ML. Diagnostic and surgical guides for placement of dental implants. J Maxillofac Surg 1994;52:642-4.  Back to cited text no. 7
    
8.Scandrett FR, Tebo HG, Miller JT, Quigley MB. Radiographic examination of the edentulous patient. I. Review of the literature and preliminary report comparing three methods. Oral Surg Oral Med Oral Pathol 1973;35:266-8.  Back to cited text no. 8
    
9.Velmurugan N, Venkateshbabu N, Abarajithan M, Kandaswamy D. Evaluation of the pulp chamber size of human maxillary first molars: An institution based in vitro study. Indian J Dent Res 2008;19:92-4.  Back to cited text no. 9
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10.Deutsch AS, Musikant BL. Morphological measurement of anatomic landmarks in human maxillary and mandibular molar pulp chambers. J Endod 2004;30:388-90.  Back to cited text no. 10
    
11.Larheim TA, Svanaes DB. Reproducibility of rotational panoramic radiography: Mandibular linear dimensions andangles. Am J Orthod Dentofacial Orthop 1986;90:45-7.  Back to cited text no. 11
    
12.Xie Q, Soikkonen K, Wolf J, Mattila K, Gong M, Ainamo A. Effect of head positioning in panoramic radiography on vertical measurements: An in vitro study. Dentomaxillofac Radiol 1996;25:61-3.  Back to cited text no. 12
    
13.Alan GL. Panoramic Imaging. In: White S, Pharoah M, editors. Oral Radiology: Principles and Interpretation, St. Louis: Mosby; 2004. p. 191-209.  Back to cited text no. 13
    
14.Sterrett JD, Pelletier H, Russell CM. Tooth thickness at the furcation entrance of lower molars. J Clin Periodontol 1996;23:621-7.  Back to cited text no. 14
    
15.Deutsch AS, Musikant BL. Morphological measurement of anatomic landmarks in pulp chambers of human maxillary and furcated bicuspids. J Endod 2005;31:570-3.  Back to cited text no. 15
    
16.Khojastepour L, Rahimizadeh N, Khayat A. Morphologic measurements of anatomic landmarks in pulp chambers of human first molars: A study of bitewing radiographs. Iran Endod J 2008;1:147-51.  Back to cited text no. 16
    
17.Chandler NP, Pitt Ford TR, Monteith BD. Coronal pulp size in molars: A study of bitewing radiographs. Int Endod J 2003;36:757-63.  Back to cited text no. 17
    
18.Pitt Ford TR, Mitchell PJ. Problems in Endodontic Treatment. In: Pitt Ford TR, editor. Harty's Endodontics in Clinical Practice. New York: Wright; 2004. p. 241-6.  Back to cited text no. 18
    
19.Shaw L, Jones AD. Morphological considerations of the dental pulp chamber from radiographs of molar and premolar teeth. J Dent 1984;12:139-45.  Back to cited text no. 19
    

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Correspondence Address:
Emre Bodrumlu
Department of Endodontics, Faculty of Dentistry, Ondokuz Mayis University, Samsun
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-9290.127624

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    Figures

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    Tables

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