Determinantes del número de conductos principales en un diente: descifrando posibles mecanismos
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dic 18, 2023
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Resumen
Antecedentes: aunque diariamente se realizan millones de tratamientos de conducto radicular en todo el mundo, aún no se han dilucidado los factores que determinan el número de conductos radiculares principales en un diente. Las variaciones en el número de conductos radiculares en diferentes dientes son de suma importancia en la práctica clínica. Sin embargo, los médicos no conocen los determinantes de tal número, y mucho menos estos determinantes han sido abordados en la literatura, según nuestro conocimiento. Objetivo: Esta revisión narrativa tuvo como objetivo integrar los posibles mecanismos involucrados en la determinación del número de conductos principales en un diente permanente. Métodos: Utilizamos los términos de búsqueda "número de conducto radicular", "morfología del conducto radicular", "morfología dental", "desarrollo radicular" y "formación radicular" para identificar artículos de las bases de datos PubMed y Scopus. Resultados: se obtuvieron 57 artículos y 2 libros. Una base multifactorial es plausible considerando la influencia de los mecanismos antropológicos, demográficos, ambientales, genéticos, epigenéticos, relacionados con el tamaño del diente y el papel fundamental de la vaina radicular epitelial de Hertwig. Las técnicas de imagen de células vivas, los modelos matemáticos, la genética cuantitativa y la fenómica dental podrían proporcionar información reveladora en un futuro próximo. Conclusiones: En general, parece que los posibles mecanismos que determinan el número de conductos principales en un diente tienen una base multifactorial. El papel orquestador de la vaina radicular epitelial de Hertwig parece fundamental, aunque las señales reguladoras específicas que inducen o reprimen sus procesos diafragmáticos siguen sin conocerse. Sin embargo, existe una gran necesidad de estudios moleculares que ayuden a revelar estos y otros posibles mecanismos involucrados.
Keywords
dental anatomy, dentistry, endodontics, Hertwig's epithelial root sheath, root canal morphology, root canal number, root canal system, tooth root development, tooth root formationanatomía dental, desarrollo de la raíz del diente, endodoncia, formación de la raíz del diente, morfología del conducto radicular, número de conductos radiculares, odontología, sistema de conductos radiculares, vaina radicular epitelial de Hertwiganatomia dentária, bainha radicular epitelial de Hertwig, desenvolvimento da raiz dentária, endodontia, formação de raiz dentária, morfologia do canal radicular, número de canais radiculares, odontologia, sistema de canais radiculares
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2. Li YH, Bao SJ, Yang XW, Tian XM, Wei B, Zheng YL. Symmetry of root anatomy and root canal morphology in maxillary premolars analyzed using cone-beam computed tomography. Arch Oral Biol. 2018 Oct; 94: 84-92. https://dx.doi.org/10.1016/j.archoralbio.2018.06.020
3. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984 Nov; 58(5): 589-599. https://dx.doi.org/10.1016/0030-4220(84)90085-9
4. Gulabivala K, Aung TH, Alavi A, Ng YL. Root and canal morphology of Burmese mandibular molars. Int Endod J. 2001 Jul; 34(5): 359-370. https://dx.doi.org/10.1046/j.1365-2591.2001.00399.x
5. Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod. 2004 Jun;30(6): 391-398. https://dx.doi.org/10.1097/00004770-200406000-00004
6. Zhang M, Xie J, Wang YH, Feng Y. Mandibular first premolar with five root canals: a case report. BMC Oral Health. 2020 Sep 10; 20(1): 253. https://dx.doi.org/10.1186/s12903-020-01241-0
7. Gomez F, Brea G, Gomez-Sosa JF. Root canal morphology and variations in mandibular second molars: an in vivo cone-beam computed tomography analysis. BMC Oral Health. 2021 Sep 1; 21(1): 424. https://dx.doi.org/10.1186/s12903-021-01787-7
8. Wolf TG, Stiebritz M, Boemke N, Elsayed I, Paqué F, Wierichs RJ, Briseño-Marroquín B. 3-dimensional Analysis and Literature Review of the Root Canal Morphology and Physiological Foramen Geometry of 125 Mandibular Incisors by Means of Micro-Computed Tomography in a German Population. J Endod. 2020 Feb; 46(2): 184-191. https://dx.doi.org/10.1016/j.joen.2019.11.006
9. Aznar Portoles C, Moinzadeh AT, Shemesh H. A Central Incisor with 4 Independent Root Canals: A Case Report. J Endod. 2015 Nov; 41(11): 1903-1906. https://dx.doi.org/10.1016/j.joen.2015.08.001
10. Zhang W, Tang Y, Liu C, Shen Y, Feng X, Gu Y. Root and root canal variations of the human maxillary and mandibular third molars in a Chinese population: A micro-computed tomographic study. Arch Oral Biol. 2018 Nov; 95: 134-140. https://dx.doi.org/10.1016/j.archoralbio.2018.07.020
11. Perrini N, Versiani MA. Historical Overview of the Studies on Root Canal Anatomy. In: Versiani MA, Basrani B, Sousa-Neto M, editors. The Root Canal Anatomy in Permanent Dentition. Cham: Springer; 2019. p.10. https://dx.doi.org/10.1007/978-3-319-73444-6_1
12. American Association of Endodontists. Healthier Mouth=Healthier You. Tooth Wisdom Infographic. https://newsroom.aae.org/healthier-you/. Accessed April 29, 2022.
13. Wang J, Feng JQ. Signaling Pathways Critical for Tooth Root Formation. J Dent Res. 2017 Oct; 96(11): 1221-1228. https://dx.doi.org/10.1177/0022034517717478
14. Zeichner-David M, Oishi K, Su Z, Zakartchenko V, Chen LS, Arzate H, Bringas P Jr. Role of Hertwig's epithelial root sheath cells in tooth root development. Dev Dyn. 2003 Dec; 228(4): 651-663. https://dx.doi.org/10.1002/dvdy.10404
15. Huang X, Xu X, Bringas P Jr, Hung YP, Chai Y. Smad4-Shh-Nfic signaling cascade-mediated epithelial-mesenchymal interaction is crucial in regulating tooth root development. J Bone Miner Res. 2010 May; 25(5): 1167-178. https://dx.doi.org/10.1359/jbmr.091103
16. Ioannidis K, Lambrianidis T, Beltes P, Besi E, Malliari M. Endodontic management and cone-beam computed tomography evaluation of seven maxillary and mandibular molars with single roots and single canals in a patient. J Endod. 2011 Jan; 37(1): 103-109. https://dx.doi.org/10.1016/j.joen.2010.09.001
17. Kottoor J, Velmurugan N, Surendran S. Endodontic management of a maxillary first molar with eight root canal systems evaluated using cone-beam computed tomography scanning: a case report. J Endod. 2011 May; 37(5): 715-719. https://dx.doi.org/10.1016/j.joen.2011.01.008
18. Arora A, Acharya SR, Sharma P. Endodontic treatment of a mandibular first molar with 8 canals: a case report. Restor Dent Endod. 2015 Feb; 40(1): 75-78. https://dx.doi.org/10.5395/rde.2015.40.1.75
19. Kovacs I. Contribution to the ontogenetic morphology of roots of human teeth. J Dent Res. 1967 Sep-Oct; 46(5): 865-874. https://dx.doi.org/10.1177/00220345670460054201
20. Brook AH. Multilevel complex interactions between genetic, epigenetic and environmental factors in the aetiology of anomalies of dental development. Arch Oral Biol. 2009 Dec; 54 Suppl 1(Suppl 1): S3-17. https://dx.doi.org/10.1016/j.archoralbio.2009.09.005
21. Shields ED. Mandibular premolar and second molar root morphological variation in modern humans: What root number can tell us about tooth morphogenesis. Am J Phys Anthropol. 2005 Oct; 128(2): 299-311. https://dx.doi.org/10.1002/ajpa.20110
22. Moore NC, Thackeray JF, Hublin JJ, Skinner MM. Premolar root and canal variation in South African Plio-Pleistocene specimens attributed to Australopithecus africanus and Paranthropus robustus. J Hum Evol. 2016 Apr; 93: 46-62. https://dx.doi.org/10.1016/j.jhevol.2015.12.002
23. Hamon N, Emonet EG, Chaimanee Y, Guy F, Tafforeau P, Jaeger JJ. Analysis of dental root apical morphology: a new method for dietary reconstructions in primates. Anat Rec (Hoboken). 2012 Jun; 295(6): 1017-1026. https://dx.doi.org/10.1002/ar.22482
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Cómo citar
Moreno Robalino, A. A., & Álvarez Vásquez, J. L. (2023). Determinantes del número de conductos principales en un diente: descifrando posibles mecanismos. Universitas Odontologica, 42. https://doi.org/10.11144/Javeriana.uo42.dnmc
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