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Root surface area has been extensively explored in the literature (Table 5-6).^104–108 While initially investigated as an important factor to aid clinicians in decision making for root resection therapy,¹³ the calculation of this area is also helpful to determine the extent of disease progression and to assist in the selection between regenerative or resective approaches.

TABLE 5-6 Average root surface area (mm²) covered by cementum*

*Adapted from Schroeder.¹⁰⁸

Hermann et al¹³ reported a total surface area for the maxillary first molar of 476.43 mm². Interestingly, the authors went further to investigate the percentage of root surface area occupied by root trunk (32%), palatal (24%), mesiobuccal (25%), and distobuccal (19%) roots (Fig 5-3a). Later, similar studies were conducted around mandibular first molars.^69,109 Dunlap and Gher reported a total surface area of 436.8 mm², and the percentage of root surface area for the root trunk, distal, and mesial root were 30.5%, 32.4%, and 37%, respectively⁶⁹ (Fig 5-3b). Box 5-3 includes a summary for the percentages of root surface area for each region in the root complex.^13,68

Fig 5-3 Percentage of root surface area of maxillary (a) and mandibular (b) first molars.

BOX 5-3 Percentage of root surface area in the root complex

Maxillary first molars(Hermann et al13)	Mandibular first molars(Gher and Dunlap68)
Root trunk	32%	Mesial root	37%
Mesiobuccal root	25%	Distal root	32.4%
Palatal root	24%	Root trunk	30.5%
Distobuccal root	19%