Atypical Radicular Anatomy in Permanent Human Teeth: A Systematic Review

Crit Rev Biomed Eng. 2022;50(1):19-34. doi: 10.1615/CritRevBiomedEng.2022043742.


The aim of the present study is to classify and quantify the anatomical variations of teeth in terms of form and number of root canals reported in human teeth employing the classification systems proposed previously. An electronic (PubMed) and manual search were performed to identify case reports noting any of the anatomical variations. Each alteration was studied independently. The electronic search was performed using the following keywords: anatomical aberration, root canal, permanent Dentition, case report, c-shaped canal, dens invaginatus, palato-radicular groove, palato-radicular groove, palato-gingival groove, radix entomolaris, dental fusion, dental gemination, taurodontism, dilaceration. The initial search revealed 1497 papers, of which 938 were excluded after analyzing the titles and abstracts. Therefore, 559 potential papers were considered. Of those, 140 articles did not meet the inclusion criteria. For the final revision, 419 papers were considered. We found that the mandibular first premolar had the highest prevalence of C-shaped canals. Dens invaginatus was more frequently found in the mandibular lateral incisor. Taurodontism was more prevalent in the maxillary first molar and in the mandibular first molar. Dilaceration was not clearly associated with a particular tooth. The classifications systems used in this review allowed for the better understanding and analysis of the many anatomical variations present in teeth. The variations in shape most found were dens invaginatus and radix entomolaris. The most frequently reported anatomical variation was in the number of canals.

Publication types

  • Case Reports
  • Systematic Review

MeSH terms

  • Dens in Dente*
  • Dental Pulp Cavity / abnormalities
  • Dentition, Permanent
  • Humans
  • Incisor
  • Tooth Abnormalities*

Supplementary concepts

  • Taurodontism