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Liu J, Zhao X, Liu Y, Dong N, Zhang X. Prevalence and anatomic associations of middle mesial canals and isthmi in mandibular first molars: A CBCT-based study in a Northern Chinese population. AUST ENDOD J 2024; 50:69-77. [PMID: 37902140 DOI: 10.1111/aej.12807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/12/2023] [Accepted: 10/17/2023] [Indexed: 10/31/2023]
Abstract
This study investigated the prevalence of the middle mesial canal (MMC) and isthmus in a northern Chinese subpopulation using cone-beam computed tomography (CBCT). CBCT images of 1060 mandibular first molars (MFMs) were analysed. Data analysis was performed using the chi-square test, t-test, and multiple logistic regression analysis (p < 0.05). The prevalence of MMC and isthmus was 15.2% and 40.6%, respectively. The average dentinal thickness in the danger zone was 1.61 ± 0.14 mm. Patients younger than 40 years were two times more likely to have MMC (odds ratio [OR] = 2.204). Additionally, for every 1 mm reduction in the MB-ML orifice distance, the likelihood of detection of MMC in MFM nearly doubled (OR = 1.738). Furthermore, MFMs with MB-ML isthmus were five times more likely to exhibit MMC than those without it (OR = 4.756). The findings revealed that the prevalence of MMC and isthmus in MFMs is high and suggested that anatomical and demographic variables can serve as valuable indicators for clinicians in anticipating their presence.
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Affiliation(s)
- Jiaojiao Liu
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Xiangyu Zhao
- Department of Oral Emergency, Shenyang Stomatological Hospital, Shenyang, China
| | - Ying Liu
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Nannan Dong
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
| | - Xiaodong Zhang
- Department of Stomatology, General Hospital of Northern Theater Command, Shenyang, China
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Kuzekanani M, Azami Sardoei M, Walsh LJ. The Prevalence of Middle Mesial Canals in the Second Mandibular Molars of an Iranian Subpopulation: A Cross-Sectional CBCT Study. Cureus 2023; 15:e51179. [PMID: 38283515 PMCID: PMC10817710 DOI: 10.7759/cureus.51179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Background Missed additional canals are a common reason for the failure of root canal treatments. The prevalence of additional canals in molar teeth can vary because of ethnic differences. Hence, this study aimed to determine the prevalence and distribution of middle mesial canals (MMCs) in the second mandibular molars using cone beam computed tomography (CBCT), for an adult population from Kerman in southeast Iran. Methodology De-identified retrospective provided CBCT scans from three private radiology centers in Kerman were reviewed (131 patients; 58 males (44.3%), 73 females (55.7%); age range: 13 to 54 years, mean age: 33). The presence of MMCs in mandibular second molars (222 teeth; 112 left and 110 right) was recorded, along with the morphology of the distal roots in the same teeth. Frequency data were analyzed using the Chi-square test and Fisher's exact test. Results The overall prevalence of MMC in the second mandibular molars was 2.3%. MMCs were found both unilaterally and bilaterally. More MMCs were found in females than males (2.7% vs. 1.7%), and on the left side (2.7% vs. 1.8%), but these differences were not statistically significant (p=1.0). There was no association between the existence of MMC in the mesial root and a second canal in the distal root of the same tooth. Conclusion Based on CBCT scans, the overall prevalence of MMC in mandibular second molars in this population was just below one in 44. Clinicians performing endodontic treatment on second molars should check for the presence of MMC so that this possible additional canal is not missed.
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Affiliation(s)
- Maryam Kuzekanani
- Department of Endodontics, Endodontology Research Center, Kerman University of Medical Sciences and Health Services, Kerman, IRN
| | - Mousa Azami Sardoei
- Department of Endodontics, Endodontology Research Center, Kerman University of Medical Sciences and Health Services, Kerman, IRN
| | - Laurence J Walsh
- Dentistry, School of Dentistry, the University of Queensland, Brisbane, AUS
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Javed MQ, Srivastava S, Alotaibi BBR, Bhatti UA, Abulhamael AM, Habib SR. A Cone Beam Computed Tomography-Based Investigation of the Frequency and Pattern of Radix Entomolaris in the Saudi Arabian Population. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2025. [PMID: 38004074 PMCID: PMC10673087 DOI: 10.3390/medicina59112025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: An understanding of the anatomical complexity of teeth is a significant factor for a successful endodontic treatment outcome. The aim of this study was to explore the frequency and pattern of distribution of radix entomolaris (RE) in mandibular first molars (MFMs) of a Saudi Arabian subpopulation using CBCT scans. Materials and Methods: This study was conducted at dental clinics of Qassim University from February to May 2023 by evaluating CBCT scans that were previously obtained for diagnostic purposes. Scans of Saudi national patients with bilaterally present MFMs and fully formed root apices were included. Conversely, scans with one/or two missing MFMs, MFMs with incomplete root apices, full- or partial-coverage prosthesis, endodontic treatment, and associated radicular resorption were excluded from study. A total of 303 CBCT scans with 606 bilateral MFMs were analyzed by two calibrated evaluators for the presence of, and type according to Song's typolgy of RE. The data were analyzed using SPPS-24. The descriptive variables were documented as frequencies and percentages. The chi-square test was used to determine the association between the prevalence of RE with the gender, jaw side and age group. Both inter-rater and intra-rater agreements were estimated for detecting and classifying RE using Cohen's kappa test. Results: The sample had 63.7% males and 36.3% females. The prevalence of RE was 6.6%, with Song's type III (57.5%) as the most common variant. Absolute agreement was noted between the raters about the presence of RE and very strong agreement was noted for the classification of the RE. Conclusions: RE is an uncommon finding among the mandibular first molars of the Saudi population without any gender and quadrant predilection. The clinicians' knowledge of the presence and Song's type of RE may contribute towards the enhancement of endodontic treatment outcomes.
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Affiliation(s)
- Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, P.O. Box 1162, Buraidah 51452, Qassim, Saudi Arabia; (S.S.); (B.B.R.A.)
| | - Swati Srivastava
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, P.O. Box 1162, Buraidah 51452, Qassim, Saudi Arabia; (S.S.); (B.B.R.A.)
| | - Badi Baen Rashed Alotaibi
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, P.O. Box 1162, Buraidah 51452, Qassim, Saudi Arabia; (S.S.); (B.B.R.A.)
| | - Usman Anwer Bhatti
- Department of Operative Dentistry, Islamic International Dental College, Riphah International University, Islamabad 44000, Pakistan;
| | - Ayman M. Abulhamael
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia;
| | - Syed Rashid Habib
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia
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Yang Y, Jiang C, Chen M, Zeng J, Wu B. Vertucci’s root canal configuration of 11,376 mandibular anteriors and its relationship with distolingual roots in mandibular first molars in a Cantonese population: a cone-beam computed tomography study. BMC Oral Health 2022; 22:130. [PMID: 35429982 PMCID: PMC9013457 DOI: 10.1186/s12903-022-02078-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/08/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Cone-beam computed tomography (CBCT) was used to study the root canal system of mandibular anteriors (MAs) in a Cantonese population and to evaluate the correlation between the complicated root canal configurations of mandibular lateral incisors (MLIs) and the presence of distolingual roots (DLRs) in mandibular first molars (MFMs).
Methods
A total of 11,376 mandibular anterior teeth were scanned by CBCT. Those whose images met the inclusion criteria were first analysed according to Vertucci's root canal configuration and then grouped based on gender, age, and side, and their effects on root canal morphology were analysed. Finally, statistical analysis was used to evaluate the correlation between the complicated root canal configurations of MLIs and the existence of DLRs in MFMs. All statistical analyses were performed by using SPSS 25.0 software. Quantitative data are presented as the mean ± standard deviation. Student’s t tests were used to calculate statistical significance. P < 0.05 was considered statistically significant.
Results
In MAs in the Cantonese population, all mandibular central incisors (MCIs) and MLIs had one root, and 0.37% of mandibular canines (MCs) had two roots. The most common Vertucci's root canal configuration was Vertucci I followed by Vertucci III. A total of 30.91% of MLIs and approximately 8% of MCIs and MCs have complicated root canal configurations. There were no significant differences in the prevalence of DLRs in MFMs and the incidence of complicated root canal configurations of MLIs between males and females or between the right and left teeth. However, a significant difference was found in different age groups of root canal configurations in MLIs. Moreover, significant ipsilateral and contralateral correlations between MFMs with DLRs and MLIs with complicated root canal configurations were observed on both sides.
Conclusion
In Cantonese population, the possibility of complicated root canal configuration in MLIs was higher, when DLR appeared in MFMs.
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Golež A, Ovsenik M, Romarić K, Cankar K. The Use of Magnetic Resonance Imaging in Diagnostics of Radix Paramolaris: A Case Report. Open Dent J 2021. [DOI: 10.2174/1874210602115010760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives:
This case report aims to present a rare morphological variation of Radix Paramolaris (RP) diagnosed using Magnetic Resonance Imaging (MRI) to discuss its morphological associations and possible implications on dental treatment. Radix paramolaris is a buccally located supernumerary root of the permanent mandibular molars. It is very rare in the European population, with a prevalence below 4%.
Case Presentation:
A 7-year-old boy with severe Class II malocclusion is presented. The first phase of orthodontic treatment consisted of therapy with a removable activator appliance. Before the second phase of treatment, unilateral radix paramolaris on the second right permanent mandibular molar was discovered.
Results:
Supernumerary root was diagnosed using a 3T whole-body MRI system. This case confirmed the association between supernumerary roots and increased buccal crown cusps in a mandibular molar. Furthermore, it demonstrated the effectiveness of non-invasive MRI as a complementary diagnostic tool, offering clear advantages in diagnosing rare morphological variations such as supernumerary roots. Unlike conventional radiography, MRI is able to distinguish the soft tissues, including the dental pulp, and does not emit ionizing radiation.
Conclusion:
To diagnose a supernumerary root and the state of its pulpal tissue, a precise radiographic and clinical examination is required since awareness of exact root morphology can be of paramount importance in clinical decision-making for several dental procedures.
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Chen JT, Wu IT, Huang RY, Lin YC, Chou YH, Lin T, Kuo PJ, Tu CC, Hou LT, Lai YL, Lu HK, Tsai CC, Yuan K, Chen CJ, Ho CS, Yang YC, Wu AYJ, Huang KC, Chiang CY, Chang PC. Recommendations for treating stage I-III periodontitis in the Taiwanese population: A consensus report from the Taiwan Academy of Periodontology. J Formos Med Assoc 2021; 120:2072-2088. [PMID: 34294496 DOI: 10.1016/j.jfma.2021.06.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/PURPOSE Based on the fundamental of the S3-level clinical practice guideline (CPG) for treating stage I-III periodontitis developed by the European Federation of Periodontology (EFP), this consensus report aimed to develop treatment recommendations for treating periodontitis in the Taiwanese population. METHODS The report was constructed by experts from the Taiwan Academy of Periodontology. The following topics were reviewed: (a) the prevalence of periodontitis in Asia and current status of treatment in Taiwan; (b) specific anatomical considerations for treating periodontitis in Asians; (d) educational and preventive interventions and supragingival plaque control; (d) subgingival instrumentation and adjunctive treatment; (e) surgical periodontal therapy; and (f) maintenance and supportive periodontal care. Recommendations were made according to the evidences from the EFP CPG, the published literature and clinical studies in Asians, and the expert opinions. RESULTS The treatment recommendations for the Taiwanese population were generally in parallel with the EFP CPG, and extra cautions during treatment and maintenance phases were advised due to the anatomical variations, such as shorter root trunk, higher prevalence of supernumerary distolingual root and lingual bony concavity in mandibular posteriors, and thinner anterior labial plate, of the Asian population. CONCLUSION The EFP CPG could be adopted for treating periodontitis and maintaining periodontal health of the Taiwanese population, and anatomical variations should be cautious when the treatment is delivered.
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Affiliation(s)
- Jung-Tsu Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Ting Wu
- Department of Dentistry, China Medical University Hospital, Taichung, Taiwan
| | - Ren-Yeong Huang
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chun Lin
- Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Hsiang Chou
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Taichen Lin
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Po-Jan Kuo
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Che-Chang Tu
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Lein-Tuan Hou
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Lin Lai
- Department of Dentistry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hsein-Kun Lu
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chi-Cheng Tsai
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kuo Yuan
- Institute of Oral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Jung Chen
- Department of Dentistry, Chi-Mei Medical Center, Tainan, Taiwan
| | | | - Yueh-Chao Yang
- Department of Dentistry, Cathay General Hospital, Taipei, Taiwan
| | - Aaron Yu-Jen Wu
- Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | | | - Cheng-Yang Chiang
- School of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Po-Chun Chang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
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Aldosimani MA, Althumairy RI, Alzahrani A, Aljarbou FA, Alkatheeri MS, AlGhizzi MA, Abughosh TK. The mid-mesial canal prevalence in mandibular molars of a Saudi population: A cone-beam computed tomography study. Saudi Dent J 2021; 33:581-586. [PMID: 34803304 PMCID: PMC8589590 DOI: 10.1016/j.sdentj.2020.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/12/2020] [Accepted: 08/16/2020] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION The aim was to assess the prevalence of Mid Mesial Canal (MMC) in the first and second mandibular molars in a Saudi subpopulation sample and assess its relation to side, gender, and age using Cone beam computed tomography (CBCT). METHODS The CBCT scans at King Saud University Dental Hospital between 2016 and 2019 were reviewed and filtered. The MMC of the mandibular molars were assessed according to Pomeranz et al. classification which was: (1) independent; (2) fin; (3) confluent with the mesiobuccal canal; and (4) confluent with the mesiolingual canal. Three calibrated observers examined the MMC on all planes at both sides. Age and gender factors were used to analyze that prevalence. A chi-squared test was used and (P ≤ 0.05) was considered to be statistically significant. RESULTS 395 patients, and 1377 teeth met the inclusion criteria. The total number of mid-mesial canals was 12 (0.9%): nine at the mandibular first molar (1.3%) and three in the mandibular second molar (0.4%). The most common type of mid-mesial canal was confluent (n = 10), of which 6 fused with the mesiobuccal canal and 4 fused with the mesiolingual canal. Two canals were of the fin type, and there was no instance of independent mid-mesial canal. There was no significant difference between all variables: tooth type, tooth side, patient gender, and patient age group (p > 0.05). CONCLUSION In this study, the most common MMC configuration was the confluent type followed by the fin type and no independent type were found. The patient side, gender and age did not influence the prevalence of the MMC.
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Affiliation(s)
- Mazen A. Aldosimani
- Division of Radiology, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Riyadh I. Althumairy
- Division of Endodontics, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Adel Alzahrani
- Division of Radiology, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahd A. Aljarbou
- Division of Endodontics, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed S. Alkatheeri
- Division of Dental Biomaterials, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Singh S, Pawar M, Podar R, Kulkarni G, Bhanushali N. Root canal morphology of South Asian Indian mandibular first, second, and third molar: A dye penetration and clearing study. J Conserv Dent 2021; 23:284-288. [PMID: 33551601 PMCID: PMC7861074 DOI: 10.4103/jcd.jcd_379_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/08/2020] [Accepted: 09/08/2020] [Indexed: 11/26/2022] Open
Abstract
Context: Studying in detail the root canal morphology specific to the Indian mandibular molars will help discern whether the root canal anatomy patterns resemble those reported internationally or are different from it. Aim: The aim is to study the root canal anatomy of Indian permanent mandibular first, second, and third molar teeth using a tooth clearing technique. Methods: The root canals of a total of 300 extracted Indian mandibular molars consisting of 100 first, second, and third molars each were accessed and injected with India ink, after which they were subjected to the clearing technique. Statistical Analysis: Data was analyzed using descriptive statistics for the computation of percentages using SPSS version 21. Results: Of the hundred first molars, 90% of teeth were two rooted with three canals, 79% had two apical foramina. 70% mesial roots of the three-rooted type showed Type I, whereas 100% distal roots and distolingual roots showed Type I Vertucci’s anatomy. About 70% mesial roots of two roots showed Type II and 90% distal canals showed Type I configuration. Among the second molars, five (5%) were single-rooted, ninety-one (91%) teeth were two rooted and four (4%) had three roots. Among the mandibular third molars, fifteen (15%) teeth had one root, sixty-three (63%) teeth had two roots, eighteen (18%) teeth had three roots, and four (4%) teeth had four roots. Conclusions: The root canal anatomic features of mandibular molars showed differences in the frequency of particular anatomic types as compared to mandibular molars from other racial backgrounds. Further comparative studies on inter-racial anatomic characteristics from various geographic locations would be beneficial.
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Affiliation(s)
- Shishir Singh
- Department of Conservative Dentistry and Endodontics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Mansing Pawar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St George Hospital Compound, Mumbai, Maharashtra, India
| | - Rajesh Podar
- Department of Conservative Dentistry and Endodontics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Gaurav Kulkarni
- Department of Conservative Dentistry and Endodontics, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Nikhil Bhanushali
- Department of Public Health Dentistry, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Qiao X, Zhu H, Yan Y, Li J, Ren J, Gao Y, Zou L. Prevalence of middle mesial canal and radix entomolaris of mandibular first permanent molars in a western Chinese population: an in vivo cone-beam computed tomographic study. BMC Oral Health 2020; 20:224. [PMID: 32807171 PMCID: PMC7433192 DOI: 10.1186/s12903-020-01218-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/12/2020] [Indexed: 02/05/2023] Open
Abstract
Background The aim of this study was to investigate the prevalence of the middle mesial canal (MMC) and radix entomolaris (RE) in mandibular first permanent molars in a western Chinese population using cone-beam computed tomography (CBCT). Methods A total of 1174 CBCT images of the mandibular first molars were collected from West China Hospital of Stomatology, Sichuan University. The following information was recorded and evaluated: the detection rate and location of the MMC and RE, the curvature of the RE, the canal configuration and bilateral symmetry. Results The detection rates of the MMC and RE were 3.41 and 25.04%, respectively, as calculated by individuals, and 1.79 and 22.15%, respectively, as calculated by total teeth. The average curvature in the buccolingual (BL) orientation (40.63 ± 14.39°) was significantly larger than that in the mesiodistal (MD) orientation (17.64 ± 7.82°) (p < 0.05). Of 587 patients, 71.72% (421/587) had bilateral symmetry according to the root canal morphology. The prevalence of three-rooted mandibular first molars was higher in males than in females, while the prevalence of two-rooted mandibular first molars was higher in females than in males. Conclusions Our results showed that the RE could be detected in almost 1/4 of the western Chinese population; thus, RE detection requires special attention and careful assessment in endodontic treatment.
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Affiliation(s)
- Xin Qiao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hualing Zhu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yujia Yan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jinglin Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiayin Ren
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Ling Zou
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Gaêta-Araujo H, Fontenele RC, Nascimento EHL, Nascimento MDCC, Freitas DQ, de Oliveira-Santos C. Association between the Root Canal Configuration, Endodontic Treatment Technical Errors, and Periapical Hypodensities in Molar Teeth: A Cone-beam Computed Tomographic Study. J Endod 2019; 45:1465-1471. [DOI: 10.1016/j.joen.2019.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 07/28/2019] [Accepted: 08/11/2019] [Indexed: 01/26/2023]
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Al Shehadat S, Waheb S, Al Bayatti SW, Kheder W, Khalaf K, Murray CA. Cone Beam Computed Tomography Analysis of Root and Root Canal Morphology of First Permanent Lower Molars in a Middle East Subpopulation. J Int Soc Prev Community Dent 2019; 9:458-463. [PMID: 31620378 PMCID: PMC6792317 DOI: 10.4103/jispcd.jispcd_41_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/03/2019] [Indexed: 11/16/2022] Open
Abstract
Aim: The aim of this study was to investigate variations in the number of roots and root canals in first permanent lower molars (FPLMs) using cone beam computed tomography (CBCT). Materials and Methods: A total of 640 CBCT images were analyzed using SIDEXIS XG software version 2.62 (Sirona Dental Systems, Bensheim, Germany). The entire root anatomy of FPLMs was investigated in three dimensions and the number of roots, root canals, and the number of canals per root were recorded. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software, version 24, (IBM Corporation, USA) to determine the relationship between root anatomy and gender, age, or tooth location (right or left side). Results: The majority of FPLMs had two roots (96%), whereas the remaining 32 FPLMs (4%) had three roots. Almost two-thirds of the sample (62.7%) had three root canals, whereas only three cases (0.4%) of the FPLMs had six canals. When comparing bilateral differences in the distribution of root canals, it was determined that a quarter of FPLMs (24.1%) had an unequal number of canals. Moreover, there were differences in the number of additional canals between the mesial and distal roots with 17.5% of the former having three canals as compared with only 0.5% of the distal root. Interestingly, not more than one canal was observed in all additional root cases. No significant differences were observed in the number of canals between males and females or between right and left sides of the examined FPLMs (P > 0.05). Conclusion: Dental clinicians should be aware of the presence of an additional root in 4% of FPLMs, and about a quarter of the cases (27%) had an extra middle mesial canal in the mesial root, which was found to be more prevalent in middle age groups.
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Affiliation(s)
- Saaid Al Shehadat
- Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Saad Waheb
- Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Saad Wahbi Al Bayatti
- Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Waad Kheder
- Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Khaled Khalaf
- Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Colin A Murray
- Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
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Madjapa HS, Minja IK. Root canal morphology of native Tanzanian permanent mandibular molar teeth. Pan Afr Med J 2018; 31:24. [PMID: 30918551 PMCID: PMC6430849 DOI: 10.11604/pamj.2018.31.24.14416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 06/15/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction Research has shown variations in morphology of root canals to differ amongst ethnic groups. We aimed to investigate the root morphology and canal configuration of permanent mandibular molars in a native Tanzanian population. Methods 146 first and 85 second mandibular molars were collected from Tanzanian patients. After removal of the pulp tissues and staining using Methylene blue ink from the canal system, the teeth were decalcified and rendered clear using 98% methyl salicylate. The teeth were then examined under magnification of 10X for: number of roots, tooth length, number of canals, location of apical foramen, presence of an apical delta and canal configuration using Vertucci's classification. Results All mandibular molars had two separate roots. The mean tooth length for mandibular 1st and 2ndmolars were 21.7 mm and 20.5mm, respectively, with no statistically significant difference in mean tooth length between males and females. All the mesial roots 1st and 2nd mandibular molars possessed two root canals, while 40.4% and 54.1% of the distal roots of 1st and 2nd molars, respectively, had two canals. The majority of the examined teeth had their apical foramen located centrally, with an apical delta present in the distal root of one-second molar. Root canal configuration types commonly reported were Type II in the mesial and Type I in the distal roots of the mandibular 1st molar; while the 2nd molar had, respectively, root types II / IV and type I. Conclusion There were observed variations in the morphology of root canals in a Tanzanian population. Caution is advised to clinicians when performing root canal treatment.
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Affiliation(s)
| | - Irene Kida Minja
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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13
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Bansal R, Hegde S, Astekar M. Morphology and prevalence of middle canals in the mandibular molars: A systematic review. J Oral Maxillofac Pathol 2018; 22:216-226. [PMID: 30158775 PMCID: PMC6097385 DOI: 10.4103/jomfp.jomfp_194_17] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objectives: The purpose of this paper is to systematically review the various studies and case reports on the morphology and prevalence of middle canals in the mandibular molars. Methodology: Electronic databases such as MEDLINE, PubMed, EBSCOhost, ScienceDirect and various journals were screened to identify published literature till March 2017 and earlier for articles related to middle canals in the human permanent mandibular molars. Obtained articles were categorized as original researches, case reports and review articles. Well-defined review questions were developed using the patient population, intervention, comparison and outcome framework to summarize the objectives: “Does middle canal vary in morphology and anatomic location? What is the prevalence of middle canals in mandibular molars? Does ethnicity affect the prevalence of middle canals in mandibular molars?” Morphology was studied and prevalence rates were determined from the evaluation of data extracted from the articles. Results: The search strategy resulted in 87 articles, of which 36 were original research papers and 51 were case reports. The prevalence of middle canals in the various populations ranged from 0.26% to 53.8%. Middle canals were reported in Europeans, Asians, Africans and South and North American populations. The prevalence of middle mesial canal and middle distal canal in various races was reported as up to 53.8% and 10%, respectively. The orifice of middle canal exists below a dentinal projection in the groove between the two main canals. They were observed in fin, confluent and independent configuration. Out of these, confluent configuration was more prevalent. Conclusion: Middle canal varies in morphology and anatomic location. Ethnicity affects the prevalence of middle canals in the mandibular molars.
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Affiliation(s)
- Rashmi Bansal
- Department of Conservative and Endodontics, Faculty of Dentistry, Udaipur, Rajasthan, India.,Department of Pacific Academy of Higher Education and Research University, Udaipur, Rajasthan, India
| | - Sapna Hegde
- Department of Pedodontics and Preventive Dentistry, Pacific Dental College and Hospital, Udaipur, Rajasthan, India
| | - Madhusudan Astekar
- Department of Oral Pathology and Microbiology, Institute of Dental Science, Bareilly, Uttar Pradesh, India
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Lee NC, Chang YH, Tu HT, Kuo CF, Yu KH, See LC. Comparison of the implementation of extra root canal treatment before and after fee schedule change in the Taiwan National Health Insurance System. J Dent Sci 2018; 13:145-150. [PMID: 30895110 PMCID: PMC6388824 DOI: 10.1016/j.jds.2017.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 07/25/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND/PURPOSE Endodontic treatment success depends on treatment of all root canals, but the implementation status is affected by various factors. We examined whether the fee payment change affected the extra root canal endodontic treatment (EXRCT) in adult teeth in the National Health Insurance (NHI) system of Taiwan since 2008. The effect of hospital level, sex, and age on EXRCT was also examined. MATERIALS AND METHODS Two longitudinal health insurance databases for 2005 and 2010 were used. Excluding third molars and endodontic retreatment, the EXRCT rate in permanent dentition were compared for different tooth positions, hospital levels, sex and age between 2005 and 2010. RESULTS In total, 80,995 teeth in 2005 and 76,018 in 2010 underwent root canal filling. The rate of EXRCT increased markedly from 2005 to 2010, particularly for the upper first molar (1.84% to 3.18%), lower first premolar (3.45% to 4.58%), lower first molar (12.4% to 18%), and lower second molar (0.95% to 1.87%). The difference between 2005 and 2010 remained statistically significant after adjustment for hospital level, sex, and age. The lower second molar had the highest adjusted odds ratio for the difference between 2005 and 2010 (1.99; CI: 1.49-2.66), followed by the upper first molar (1.91; CI: 1.55-2.35), lower first molar (1.60; CI: 1.47-1.75), and lower first premolar (1.38; CI: 1.11-1.72). CONCLUSION The payment change of Taiwan NHI seems to encourage the use of EXRCT in molars. Hospital level, sex, and age also affected the rate of EXRCT.
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Affiliation(s)
- Nien-Chieh Lee
- Department of General Dentistry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yen-Hsiang Chang
- Department of General Dentistry, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan
| | - Hui-Tzu Tu
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chang-Fu Kuo
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
| | - Kuang-Hui Yu
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
| | - Lai-Chu See
- Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan 33305, Taiwan
- Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan 33302, Taiwan
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15
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Alswilem R, Abouonq A, Iqbal A, Alajlan SS, Alam MK. Three-Dimensional Cone-Beam Computed Tomography Assessment of Additional Canals of Permanent first Molars: A Pinocchio for Successful Root Canal Treatment. J Int Soc Prev Community Dent 2018; 8:259-263. [PMID: 29911065 PMCID: PMC5985684 DOI: 10.4103/jispcd.jispcd_3_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 03/25/2018] [Indexed: 11/06/2022] Open
Abstract
AIMS AND OBJECTIVES The objective of this study was to estimate the prevalence of additional canals in the first permanent molars of the participants of Saudi, Jordanian, and Egyptian population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS In this retrospective study, CBCT scans of 139 patients were collected who were implant treated at College of Dentistry, Al Jouf University, Saudi Arabia, from October 2016 to March 2017. The images were analyzed using On-Demand 3D software. A pilot study was done to prevent intra-examiner error, and two calibrated examiners independently assessed 20% randomly selected CBCT images. Gender and racial disparities were analyzed using Chi-square test. P <0.05 was considered statistically significant. RESULTS The prevalence of additional canal in U16, U26, L36, and L46 of Saudi population was 41.80%, 41.80%, 17.30%, and 19.10%, respectively. In Jordanian participants, no additional canals were found in both mandibular first molars whereas only one participant from Egypt had additional canal in both mandibular first molars. Moreover, significant associations were found between L36 (P = 0.015) and L46 (P = 0.008) with gender. CONCLUSION In conclusion, the results of this study provide the information about the prevalence of additional canal in the first permanent molars, which will help and guide the clinicians while performing root canal treatment and also may help them increase the success rate of root canal treatment of the first permanent molars.
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Affiliation(s)
- Rayan Alswilem
- College of Dentistry, Al Jouf University, Sakaka, Saudi Arabia
| | - Anas Abouonq
- College of Dentistry, Al Jouf University, Sakaka, Saudi Arabia
| | - Azhar Iqbal
- Department of Restorative Dentistry, College of Dentistry, Al Jouf University, Sakaka, Saudi Arabia
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Wu YC, Cheng WC, Weng PW, Chung MP, Su CC, Chiang HS, Tsai YWC, Chung CH, Shieh YS, Huang RY. The Presence of Distolingual Root in Mandibular First Molars Is Correlated with Complicated Root Canal Morphology of Mandibular Central Incisors: A Cone-beam Computed Tomographic Study in a Taiwanese Population. J Endod 2018; 44:711-716.e1. [DOI: 10.1016/j.joen.2018.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/09/2018] [Accepted: 01/14/2018] [Indexed: 10/17/2022]
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17
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Tomaszewska IM, Skinningsrud B, Jarzębska A, Pękala JR, Tarasiuk J, Iwanaga J. Internal and external morphology of mandibular molars: An original micro-CT study and meta-analysis with review of implications for endodontic therapy. Clin Anat 2018; 31:797-811. [DOI: 10.1002/ca.23080] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/08/2018] [Accepted: 03/20/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Iwona M. Tomaszewska
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Bendik Skinningsrud
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Anna Jarzębska
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
| | - Jakub R. Pękala
- Department of Anatomy; Jagiellonian University Medical College; Krakow Poland
- International Evidence-Based Anatomy Working Group; Krakow Poland
| | - Jacek Tarasiuk
- Micro- and Nanotomography Laboratory, Faculty of Physics; AGH University of Science and Technology; Krakow Poland
| | - Joe Iwanaga
- Seattle Science Foundation; Seattle Washington
- Department of Anatomy, Kurume University School of Medicine; Division of Gross and Clinical Anatomy; Kurume Fukuoka Japan
- Dental and Oral Medical Center, Kurume University School of Medicine; Kurume Fukuoka Japan
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18
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Marceliano-Alves MF, Lima CO, Bastos LGDPMN, Bruno AMV, Vidaurre F, Coutinho TM, Fidel SR, Lopes RT. Mandibular mesial root canal morphology using micro-computed tomography in a Brazilian population. AUST ENDOD J 2018; 45:51-56. [PMID: 29611889 DOI: 10.1111/aej.12265] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2018] [Indexed: 12/15/2022]
Abstract
To assess the root canal system morphology of mandibular molars by means of micro-computed tomography, one hundred and four mandibular first molars were investigated and the following were evaluated: Vertucci's classification, the presence of lateral canals and the number of apical foramina. Mesial root canal surface area and volume were obtained by the CTAn and CTvol software. The type of root canal isthmi was classified applying the Hsu & Kim and Fan criteria. The most frequent root canal configuration was Vertucci type IV (46.2%). Lateral canals were observed in all root canal thirds and the average number of apical foramina was 3.15 ± 1.77. Regarding the presence of isthmus, Types I and II were the most prevalent, according to Hsu & Kim and Fan et al. criteria, respectively. Mesial root canals of mandibular molars showed high morphology variability.
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Affiliation(s)
| | | | | | | | - Fernanda Vidaurre
- Department of Endodontics, Rio de Janeiro Federal University, Rio de Janeiro, Brazil
| | | | - Sandra Rivera Fidel
- Department of Endodontics, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ricardo Tadeu Lopes
- Metallurgical and Materials Engineering, Rio de Janeiro Federal University, Rio de Janeiro, RJ, Brazil
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Ni N, Cao S, Han L, Zhang L, Ye J, Zhang C. Cone-beam computed tomography analysis of root canal morphology in mandibular first molars in a Chinese population: a clinical study. ACTA ACUST UNITED AC 2018. [DOI: 10.1186/s41121-018-0015-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Abstract
Background
The aim of this study was to evaluate the root canal morphology of mandibular first molars in a Chinese population by using cone-beam computed tomography (CBCT).
Methods
In this study, CBCT images of 900 mandibular first molars were evaluated for the following details: (1) number of roots, (2) number of apical foramina, (3) frequency distribution of root canal configurations defined in accordance with Vertucci’s classification, and (4) frequency of occurrence of middle mesial (MM) canal.
Results
Overall, 74.9% of the evaluated mandibular first molars possessed two roots, and 55.4% exhibited three apical foramina. The evaluated teeth exhibited a relatively high prevalence of type IV canals in mesial (M) roots (76.8%) and type I canals in the distal (D) (79.4%), distobuccal (DB) (98.7%), and distolingual (DL) (100%) roots. There were no significant differences in the number of roots, incidence of apical foramina, or distribution of different canal configurations of mandibular first molars between men and women (P > 0.05). 1.9% of mandibular first molars possessed three mesial canals, and the highest frequency of occurrence of MM canals (4.1%) was among Chinese people below the age of 30 years.
Conclusions
CBCT scanning facilitates identification of the root canal system. In order to increase the success rate of treatment, it is important to obtain information about the variable morphology of root canals before endodontic treatment.
Trial registration
TJSKE20160412. Registered 12 April 2016.
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Morphological Characteristics and Classification of Mandibular First Molars Having 2 Distal Roots or Canals: 3-Dimensional Biometric Analysis Using Cone-beam Computed Tomography in a Korean Population. J Endod 2018; 44:46-50. [DOI: 10.1016/j.joen.2017.08.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 03/02/2017] [Accepted: 08/02/2017] [Indexed: 11/18/2022]
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21
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Wu YC, Cheng WC, Chung MP, Su CC, Weng PW, Cathy Tsai YW, Chiang HS, Yeh HW, Chung CH, Shieh YS, Huang RY. Complicated Root Canal Morphology of Mandibular Lateral Incisors Is Associated with the Presence of Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in a Taiwanese Population. J Endod 2017; 44:73-79.e1. [PMID: 29079050 DOI: 10.1016/j.joen.2017.08.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 08/21/2017] [Accepted: 08/26/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of this study was to assess the root canal configurations in permanent mandibular lateral incisors (PMLIs) and the correlation between the root canal configurations of PMLIs with the appearance of a distolingual root (DLR) in permanent mandibular first molars (PMFMs) using cone-beam computed tomographic (CBCT) imaging. METHODS A total of 1200 CBCT images (300 patients) of PMFMs and PMLIs were investigated. The frequency and distribution of DLRs in PMFMs along with root canal configurations of PMLIs were assessed ipsilaterally and contralaterally. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMLIs with the appearance of a DLR in PMFMs. RESULTS The prevalence of PMFMs with a DLR was 24.3%, and the incidence of complicated root canal configurations in PMLIs was 25.0%. The most prevalent root canal systems of PMLIs were Vertucci types I (75%) and III (23.0%). The incidence of complicated root canal configurations in PMLIs was 19.5% in the non-DLR group (ie, no DLR was found on either side of the PMFMs), 33.3% in the unilateral DLR (Uni-DLR) group (ie, a DLR was found in 1 of the PMFMs [the left or right side] and a DLR was not found on the other PMFM), and 39.8% in the bilateral DLR (Bil-DLR) group (ie, a DLR was found in both the right and left PMFMs). After adjusting for categoric variables including sex, age, and side, the odds ratios for the frequency of complicated root canal configurations of PMLIs in the Uni-DLR and Bil-DLR groups compared with the non-DLR group were 2.12 (P = .003) and 2.707 (P < .001), respectively. CONCLUSIONS The simultaneous appearance of DLRs in PMFMs and complicated root canal configurations in PMLIs is prominent in Taiwanese individuals. Clinicians should be aware of the correlation between the anatomic variants of PMFMs and PMLIs, which are important before endodontic treatment.
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Affiliation(s)
- Yu-Chiao Wu
- Department of Operative Dentistry and Endodontics, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan
| | - Wan-Chien Cheng
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan
| | - Ming-Pang Chung
- Department of Operative Dentistry and Endodontics, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan
| | - Chi-Chun Su
- Department of Operative Dentistry and Endodontics, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan
| | - Pei-Wei Weng
- Department of Orthopaedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; Department of Orthopaedics, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yi-Wen Cathy Tsai
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan
| | - Ho-Sheng Chiang
- Department of Operative Dentistry and Endodontics, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan
| | - Hsiao-Wen Yeh
- Department of Operative Dentistry and Endodontics, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan
| | - Chi-Hsiang Chung
- School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Shing Shieh
- Department of Operative Dentistry and Endodontics, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan
| | - Ren-Yeong Huang
- Department of Periodontology, School of Dentistry, Tri-Service General Hospital and National Defense Medical Center, New Taipei City, Taiwan.
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Zhang X, Xu N, Wang H, Yu Q. A Cone-beam Computed Tomographic Study of Apical Surgery-related Morphological Characteristics of the Distolingual Root in 3-rooted Mandibular First Molars in a Chinese Population. J Endod 2017; 43:2020-2024. [PMID: 29033081 DOI: 10.1016/j.joen.2017.07.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/17/2017] [Accepted: 07/30/2017] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Apical surgery on the separate distolingual (DL) root of a 3-rooted mandibular first molar is thought to be difficult because DL roots are always severely curved, small, and shorter than distobuccal (DB) roots, and they are located far from the buccal cortical bone. The purpose of this study was to use cone-beam computed tomographic images to investigate the apical surgery-related morphological characteristics of DL roots in a Chinese population. METHODS The screening process identified 83 subjects with 128 mandibular first molars with separate DL roots. The degree of root canal curvature was measured in the mesiodistal (MD) and buccolingual (BL) planes using the Schneider method. Distances were measured from the DL root apex to the buccal cortical bone, to the buccal cortical bone opposite the DB root apex, and to the buccal cortical bone opposite the mesiobuccal (MB) root apex. The lengths of the remaining DB, MB, and DL roots were measured after resection of 3 mm of the DL apical root. Angulations of the DL root canal were determined before and after DL apical root resection. RESULTS The teeth were classified into 3 types: type I, straight in the MD and BL planes; type II, straight in the MD plane and curved in the BL plane; and type III, curved in the MD and BL planes. Only 5 molars (3.9%) were classified as type I, whereas 52 (40.6%) molars were type II and 71 (55.5%) molars were type III. The type I DL root has a significantly shorter length and longer distance from the DL root apex to the buccal cortical bone than type II and III roots (P < .05). The distance from the DL root apex to the buccal cortical bone opposite the MB root apex is significantly longer than the distance to the buccal cortical bone opposite the DB root apex in types I and II (P < .05), whereas the distance is nearly equal for type III. The angulations for root-end preparation of types II and III DL roots vary from 57.5° to 129.1° and from 55.8° to 128.1°, respectively. CONCLUSIONS A new classification was proposed for DL roots in 3-rooted mandibular first molars based on the root canal curvature. Type I is unsuitable for apical surgery. Access to the type II DL root apex should be through the DB root apex, whereas access to the type III DL root apex through the MB root apex is more feasible. Apical surgery on types II and III DL roots may be accomplished when the depth of the root-end preparation is reasonably reduced, and fine and personalized angulated ultrasonic retro tips are used.
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Affiliation(s)
- Xiao Zhang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Ning Xu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Hanguo Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China.
| | - Qing Yu
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi Key Laboratory of Oral Diseases, Department of Operative Dentistry and Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
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Zand V, Mokhtari H, Zonouzi HR, Shojaei SN. Root Canal Morphologies of Mesiobuccal Roots of Maxillary Molars using Cone beam Computed Tomography and Periapical Radiographic Techniques in an Iranian Population. J Contemp Dent Pract 2017; 18:745-749. [PMID: 28874634 DOI: 10.5005/jp-journals-10024-2119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of this study was to evaluate the accuracy of the results of cone beam computed tomography (CBCT) examinations, confirm the presence or absence of the second mesiobuccal (MB2) root canal in maxillary first and second molars, estimate the distance between the root canal orifices, observe the root types based on Vertucci classification system, and make comparisons between CBCT and periapical techniques in relation to the identification of the root canal form and the second root canal of the MB root. MATERIALS AND METHODS The CBCT and periapical radiographic data from the Department of Maxillofacial Radiology were used to select 156 individuals (78 females and 78 males) for the evaluation of the anatomy of maxillary first and second molars. RESULTS The prevalence rate of the second root canal in the MB root in the maxillary first molars was 55.1%, with 44.1 and 63.3% in females and males respectively. The prevalence rate in maxillary second molars was 23.7%, with 15.7 and 30.2% in females and males respectively. In addition, the longest and shortest distances between the root canal orifices were 2.4 and 0.3 mm respectively, with a mean of 1.3 mm. CONCLUSION There was a significant difference between the results of periapical and CBCT radiographic techniques in relation to the presence or absence of the second root canal in the MB roots of maxillary first and second molars (p < 0.01), with better results being provided by the CBCT technique. CLINICAL SIGNIFICANCE The results of CBCT images about the existence of the second root canal in the MB roots of maxillary first and second molars are more reliable, and we can use this technique in the finding of additional canals in the clinic. Keyword: Cone beam computed tomography, Dental radiography, Root canal therapy.
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Affiliation(s)
- Vahid Zand
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hadi Mokhtari
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran, Phone: +989143131992, e-mail:
| | - Hamid Rm Zonouzi
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sahand N Shojaei
- Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Wu YC, Su CC, Tsai YWC, Cheng WC, Chung MP, Chiang HS, Hsieh CY, Chung CH, Shieh YS, Huang RY. Complicated Root Canal Configuration of Mandibular First Premolars Is Correlated with the Presence of the Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in Taiwanese Individuals. J Endod 2017; 43:1064-1071. [DOI: 10.1016/j.joen.2017.01.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/13/2017] [Accepted: 01/17/2017] [Indexed: 10/19/2022]
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25
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Ghobashy AM, Nagy MM, Bayoumi AA. Evaluation of Root and Canal Morphology of Maxillary Permanent Molars in an Egyptian Population by Cone-beam Computed Tomography. J Endod 2017; 43:1089-1092. [PMID: 28476465 DOI: 10.1016/j.joen.2017.02.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Revised: 02/19/2017] [Accepted: 02/20/2017] [Indexed: 01/27/2023]
Abstract
INTRODUCTION The purpose of this study was to evaluate the number of roots and canal morphology of maxillary permanent molars in an Egyptian population. METHODS Six hundred fifty-seven cases were included in this study. Digitized images from cone-beam computed tomographic scanning were assessed by 2 endodontists. The number of roots and canal configuration according to Vertucci were tabulated. Age, sex, and bilateral distribution differences were calculated. RESULTS All maxillary first molars showed 3-root configuration, whereas maxillary second molars showed 3-, 2-, and single-root configurations. For maxillary first molars, the most common Vertucci classifications for the mesiobuccal root were type II (2-1, 45.6%), type IV (2-2, 27.27%), and type I (1, 25.45%). For maxillary second molars, the most common Vertucci classifications for the mesiobuccal root were type II (2-1, 47.1%), type I (1, 42.06%), and type IV (2-2, 8.03%). The prevalence of a second mesiobuccal canal is statistically not affected by either sex, tooth position (right or left side), or age. CONCLUSIONS Under the conditions of this study, the root canal configurations of an Egyptian population showed that the most common Vertucci classifications for the mesiobuccal root for maxillary first molars were type II (2-1), type IV (2-2), and type I (1). For maxillary second molars, the most common types were type II (2-1), type I (1), and type IV (2-2). Pre-evaluation of the endodontic case using cone-beam computed tomographic digital imaging provides better information of root canal morphology, which might improve the management and prognosis of the case.
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Affiliation(s)
- Ahmed Mostafa Ghobashy
- Department of Endodontics, Faculty of Dentistry, Misr International University, Cairo, Egypt
| | - Mohamed Mokhtar Nagy
- Department of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt.
| | - Amr Ahmed Bayoumi
- Department of Endodontics, Faculty of Dentistry, Misr International University, Cairo, Egypt
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Lee WC, Ni CW, Lin FG, Chiang CY, Li CH, Chiu HC, Fu E. Crown morphology of the mandibular first molars with distolingual roots. J Dent Sci 2016; 11:189-195. [PMID: 30894970 PMCID: PMC6395370 DOI: 10.1016/j.jds.2015.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 06/30/2015] [Indexed: 11/18/2022] Open
Abstract
Background/purpose Most mandibular first molars have two roots. A major common variation of this tooth is the presence of a distolingual root, which is a common Mongoloid trait in certain populations. The aim of this article was to examine crown morphology in relation to the presence of the distolingual root. Materials and methods Using dental casts, the crown morphology of 141 mandibular first molars from 71 Taiwanese individuals was analyzed. Periapical radiographs were used to detect distolingual roots. The length and width of the crowns and the crown units (i.e., trigonid and talonid) were measured. Ten intercuspal distances and five cusp angles were examined. Results The buccolingual dimension of the crown and its ratio to the mesiodistal dimension were significantly increased in molars with a distolingual root, compared to molars without a distolingual root. Mesiodistal crown dimensions were similar; however, the crown unit dimensions were different: molars with a distolingual root had a shorter mesiodistal trigonid dimension but a longer talonid dimension, compared to molars without a distolingual root. The intercuspal distances from the three buccal cusps to the distolingual cusp were significantly longer, however, the distance between the mesiobuccal cusp and mesiolingual cusp was significantly shorter in teeth with a distolingual root than in teeth without a distolingual root. A significantly wider mesiolingual angle and narrower distolingual angle were observed in molars with a distolingual root, compared to molars without a distolingual root. Conclusion The presence of a distolingual root significantly increased the buccolingual dimension of the crown and the location of distolingual cusp is significantly closer to the lingual side.
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Affiliation(s)
- Wei-Cheng Lee
- Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
- Division of Orthodontics and Dentofacial Orthopedics, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Chih-Wei Ni
- Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Fu-Gong Lin
- School of Public Health, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Cheng-Yang Chiang
- Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Chung-Hsing Li
- Division of Orthodontics and Dentofacial Orthopedics, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Hsien-Chung Chiu
- Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
| | - Earl Fu
- Department of Periodontology, School of Dentistry, National Defense Medical Center, Taipei City, Taiwan, ROC
- Corresponding author. Department of Periodontology, School of Dentistry, National Defense Medical Center, Number 161, Section 6, Minquan E Road, Neihu District, Taipei City 114, Taiwan, ROC.
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Cone beam CT evaluation of mandibular molar root canal morphology in a Turkish Cypriot population. Clin Oral Investig 2016; 20:2221-2226. [DOI: 10.1007/s00784-016-1742-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 01/26/2016] [Indexed: 10/22/2022]
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Middle mesial canals in mandibular first molars: A micro-CT study in different populations. Arch Oral Biol 2016; 61:130-7. [DOI: 10.1016/j.archoralbio.2015.10.020] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 09/26/2015] [Accepted: 10/21/2015] [Indexed: 11/21/2022]
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Zhang X, Xiong S, Ma Y, Han T, Chen X, Wan F, Lu Y, Yan S, Wang Y. A Cone-Beam Computed Tomographic Study on Mandibular First Molars in a Chinese Subpopulation. PLoS One 2015; 10:e0134919. [PMID: 26241480 PMCID: PMC4524594 DOI: 10.1371/journal.pone.0134919] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 07/15/2015] [Indexed: 12/03/2022] Open
Abstract
The purpose of this study was to conduct a cone-beam computed tomographic (CBCT) investigation on the root and canal configuration of the mandibular first molars, especially the morphology of the disto-lingual (DL) root, in a Chinese subpopulation. A total of 910 CBCT images of the mandibular first molars were collected from 455 patients who underwent CBCT examinations as a preoperative assessment for implants or orthodontic treatment. The following information was analyzed and evaluated: tooth position, gender, root and root canal number per tooth, root canal type of the mesial root(s) and distal root(s), angle of the DL root canal curvature, distance between two distal canal orifices in the teeth with DL root, and angle of disto-buccal canal orifice–disto-lingual canal orifice–mesio-lingual canal orifice (DB-DL-ML). Most of the mandibular first molars (64.9%, n = 591) had two roots with three root canals, and most of the mesial root canals (87.7%, n = 798) were type VI. The prevalence of the DL root was 22.1% (n = 201). The right side had a higher prevalence of DL root than the left side (p<0.05). Additionally, the curvature of the DL root canal were greater in the bucco-lingual (BL) orientation (30.10°±14.02°) than in the mesio-distal (MD) orientation (14.03°± 8.56°) (p<0.05). Overall there was a high prevalence of DL root in the mandibular first molars, and most of the DL roots were curved in different degrees. This study provided detailed information about the root canal morphology of the mandibular first molars in a Chinese subpopulation.
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Affiliation(s)
- Xin Zhang
- VIP Center and Shandong Provincial Key Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
| | - Shijiang Xiong
- VIP Center and Shandong Provincial Key Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
| | - Yue Ma
- VIP Center and Shandong Provincial Key Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
| | - Ting Han
- Department of Endodontics, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
| | - Xinyu Chen
- VIP Center and Shandong Provincial Key Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
| | - Fang Wan
- VIP Center and Shandong Provincial Key Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
| | - Yating Lu
- VIP Center and Shandong Provincial Key Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
| | - Songhe Yan
- VIP Center and Shandong Provincial Key Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
| | - Yan Wang
- VIP Center and Shandong Provincial Key Laboratory of Oral Biomedicine, School and Hospital of Stomatology, Shandong University, Jinan, Shangdong, China
- * E-mail:
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Kim Y, Perinpanayagam H, Lee JK, Yoo YJ, Oh S, Gu Y, Lee SP, Chang SW, Lee W, Baek SH, Zhu Q, Kum KY. Comparison of mandibular first molar mesial root canal morphology using micro-computed tomography and clearing technique. Acta Odontol Scand 2015; 73:427-32. [PMID: 25385684 DOI: 10.3109/00016357.2014.976263] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Micro-computed tomography (MCT) with alternative image reformatting techniques shows complex and detailed root canal anatomy. This study compared two-dimensional (2D) and 3D MCT image reformatting with standard tooth clearing for studying mandibular first molar mesial root canal morphology. MATERIALS AND METHODS Extracted human mandibular first molar mesial roots (n=31) were scanned by MCT (Skyscan 1172). 2D thin-slab minimum intensity projection (TS-MinIP) and 3D volume rendered images were constructed. The same teeth were then processed by clearing and staining. For each root, images obtained from clearing, 2D, 3D and combined 2D and 3D techniques were examined independently by four endodontists and categorized according to Vertucci's classification. Fine anatomical structures such as accessory canals, intercanal communications and loops were also identified. RESULTS Agreement among the four techniques for Vertucci's classification was 45.2% (14/31). The most frequent were Vertucci's type IV and then type II, although many had complex configurations that were non-classifiable. Generally, complex canal systems were more clearly visible in MCT images than with standard clearing and staining. Fine anatomical structures such as intercanal communications, accessory canals and loops were mostly detected with a combination of 2D TS-MinIP and 3D volume-rendering MCT images. CONCLUSIONS Canal configurations and fine anatomic structures were more clearly observed in the combined 2D and 3D MCT images than the clearing technique. The frequency of non-classifiable configurations demonstrated the complexity of mandibular first molar mesial root canal anatomy.
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Affiliation(s)
- Yeun Kim
- Department of Conservative Dentistry, Dental Research Institute, Seoul National University School of Dentistry , Seoul , Republic of Korea
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Souza-Flamini LE, Leoni GB, Chaves JFM, Versiani MA, Cruz-Filho AM, Pécora JD, Sousa-Neto MD. The Radix Entomolaris and Paramolaris: A Micro–Computed Tomographic Study of 3-rooted Mandibular First Molars. J Endod 2014; 40:1616-21. [DOI: 10.1016/j.joen.2014.03.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 03/06/2014] [Accepted: 03/11/2014] [Indexed: 02/08/2023]
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Štamfelj I. Endodontic Management of the Three-Rooted Mandibular First Permanent Molar: a Case Report. Acta Stomatol Croat 2014; 48:216-23. [PMID: 27688369 DOI: 10.15644/asc48/3/6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The distal root of the mandibular first permanent molar (MFPM) contains one or two canals. More rarely, the second/third distal canal is found in a separate root in a distolingual (DL) position - a radix entomolaris (RE). In Caucasians, this occurs in less than 4% of cases, but it is equally important to be aware of this possibility. Careful examination of the preoperative periapical radiographs (orthoradial and mesially angled) and inspection of the pulp chamber floor during endodontic management may indicate that this radicular variant is present. RE's lingual inclination and buccolingual curvature must be taken into account during cleaning and shaping of the canal within this root to avoid procedural errors, such as straightening and ledging of the root canal, perforation or instrument fracture. The aim of the present paper was to discuss a case report of a young patient, referred to an endodontic office after a ledge was created by inappropriate instrumentation of a buccolingually curved RE canal.
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Affiliation(s)
- Iztok Štamfelj
- Department of Dental Diseases and Dental Morphology, Faculty of Medicine, University of Ljubljana
Department of Operative Dentistry and Endodontics, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Guo J, Vahidnia A, Sedghizadeh P, Enciso R. Evaluation of Root and Canal Morphology of Maxillary Permanent First Molars in a North American Population by Cone-beam Computed Tomography. J Endod 2014; 40:635-9. [DOI: 10.1016/j.joen.2014.02.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 02/04/2014] [Accepted: 02/09/2014] [Indexed: 10/25/2022]
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Evaluation of Root Canal Configuration of Mandibular First Molars in a Palestinian Population by Using Cone-Beam Computed Tomography: An Ex Vivo Study. INTERNATIONAL SCHOLARLY RESEARCH NOTICES 2014; 2014:583621. [PMID: 27379321 PMCID: PMC4897246 DOI: 10.1155/2014/583621] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Revised: 05/27/2014] [Accepted: 05/28/2014] [Indexed: 11/17/2022]
Abstract
Aim. The purpose of this study was to investigate the number of canals and variations in root canal configuration in the mandibular permanent first molar teeth of a Palestinian population using cone-beam computed tomography (CBCT). Methods. A sample of 320 extracted double-rooted mandibular permanent first molars from Palestinian population was collected for this study and scanned with CBCT scanner. The following observations were made: number of root canals per root and canal configuration in each root based on Vertucci's classification. Results. Of the 320 mandibular first molars analyzed, 174 (54.4%) had three canals, 132 teeth (41.3%) had four canals, and only four teeth had two canals. The most common canal configuration in the mesial roots was Vertucci type IV (53.8%) followed by type II (38.8%). In the distal roots, the most prevalent canal configuration was Vertucci type I (57.5%) followed by type II ( 22.5%) and type III (10.6%). Conclusion. Our results showed that the number of canals and canal configuration in Palestinian population were consistent with previously reported data. The present study also indicates that CBCT is helpful as a diagnostic tool for the investigation of root canal morphology.
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Kim SY, Kim BS, Woo J, Kim Y. Morphology of Mandibular First Molars Analyzed by Cone-beam Computed Tomography in a Korean Population: Variations in the Number of Roots and Canals. J Endod 2013; 39:1516-21. [DOI: 10.1016/j.joen.2013.08.015] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 08/04/2013] [Accepted: 08/09/2013] [Indexed: 11/17/2022]
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Ballullaya SV, Vemuri S, Kumar PR. Variable permanent mandibular first molar: Review of literature. J Conserv Dent 2013; 16:99-110. [PMID: 23716959 PMCID: PMC3659872 DOI: 10.4103/0972-0707.108176] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2012] [Revised: 08/15/2012] [Accepted: 08/23/2012] [Indexed: 11/16/2022] Open
Abstract
Introduction: The success of root canal therapy depends on the locations of all the canals, thourough debridement and proper sealing. At times the clinicians are challenged with variations in morphology of root canal. This review article attempts to list out all the variations of permanent mandibular first molar published so for in the literature. Materials and Methods: An exhaustive search was undertaken using PUBMED database to identify published literature from 1900 to 2010 relating to the root canal morphology of permanent first molar by using key words. The selected artcles were obtained and reviewed. Results: Total ninty seven articles were selected out of which 50 were original article and forty seven were case reports. The incidence of third canal in mesial root was 0.95% to 15%. The incidence of three rooted mandibular first molar was 3% to 33%. Only ninety cases reported with c-shape canal configuration. Incidence of Taurodintism without congenital disorder was very rare. Conclusion: The root canal treatment requires proper knowlegde of variations in root canal morphology in order to recognise, disinfect and seal all portal of exit. This can be accomplished with proper diagnosis using newer modes, modification in access preparation, use of operating microscope, enhanced methods of disinfecting and sealing of all canals.
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Affiliation(s)
- Srinidhi V Ballullaya
- Department of Conservative dentistry and Endodontics, St Joseph Dental College, Duggirala, Eluru, West Godavari District, India
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Miloglu O, Arslan H, Barutcigil C, Cantekin K. Evaluating root and canal configuration of mandibular first molars with cone beam computed tomography in a Turkish population. J Dent Sci 2013. [DOI: 10.1016/j.jds.2012.09.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Concurrent relationship between additional canals of mandibular first molars and maxillary first molars using cone-beam computed tomography. Oral Radiol 2012. [DOI: 10.1007/s11282-012-0115-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Abella F, Patel S, Durán-Sindreu F, Mercadé M, Roig M. Mandibular first molars with disto-lingual roots: review and clinical management. Int Endod J 2012; 45:963-78. [DOI: 10.1111/j.1365-2591.2012.02075.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Incidence of three roots and/or four root canals in the permanent mandibular first molars in a Korean sub-population. Clin Oral Investig 2012; 17:105-11. [PMID: 22323057 DOI: 10.1007/s00784-012-0687-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 01/30/2012] [Indexed: 10/14/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the prevalence of three-rooted permanent mandibular first molars (PMFMs) with four canals and their morphological characteristics among a Korean population from using cone-beam computed tomography scans (CBCTs). MATERIALS AND METHODS Among the 705 CBCTs screened, 472 patient cases possessing at least one PMFM were identified. A total of 780 PMFMs were evaluated in axial section series to determine the number of roots and canals. The incidences of three-rooted PMFMs were compared with regard to gender and location. For distal root(s) with two canals, inter-orifice distances (IOD) between distobuccal and distolingual canals were measured at pulpal floor and furcation levels. The difference of IOD between males and females was also analyzed using chi-square tests. RESULTS Among the 472 CBCTs of 225 females and 247 males, 84 females and 107 males were found to have at least one three-rooted PMFM. Among the 780 PMFMs, 191 PMFMs (24.5%, 89 of 397 left and 102 of 383 right) were found to have three roots. The prevalence of distal root(s) with two canals was 34.2% (267 of 780). From the molars with two distal canals, the mean IOD between distobuccal and distolingual canals at the pulpal floor level was 3.1 mm in males and 2.9 mm in females (p = 0.0428). CONCLUSIONS The occurrence of three-rooted PMFMs among a Korean population was 24.5% and was higher than other countries and ethnicities. Understanding the prevalence of PMFMs with a distolingual root and/or canal in a Korean population and the IOD between distobuccal and distolingual canals may be useful for successful endodontic treatments. CLINICAL RELEVANCE Acknowledgment of potential incidence of three-rooted permanent mandibular first molars with four canals and the distance between two distal canals may increase the success rate of root canal treatment by reducing the missing canal untreated.
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Abella F, Mercadé M, Duran-Sindreu F, Roig M. Managing severe curvature of radix entomolaris: three-dimensional analysis with cone beam computed tomography. Int Endod J 2011; 44:876-85. [PMID: 21671948 DOI: 10.1111/j.1365-2591.2011.01898.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To present a case of a mandibular first molar with an additional distolingual root [radix entomolaris (RE)] and to discuss the use of cone beam computed tomography (CBCT) for its identification and management during root canal treatment. SUMMARY A 52-year-old Caucasian woman was referred for root canal treatment of the right mandibular first molar (tooth 46). After clinical and radiographic examination, a symptomatic irreversible pulpitis was diagnosed. Three periapical radiographs with different horizontal angulations revealed the presence of an additional distolingual root. This extra root, termed RE, has an incidence of <5% in the Caucasian population. A CBCT examination was also taken, which revealed a severe root canal curvature, especially in the middle third, of this supernumerary root. CBCT provided more accurate information in terms of RE inclination and root canal curvature before commencing root canal treatment. The conventional access opening was modified into a more trapezoidal cavity, and five root canals were found. All canals were instrumented with new nickel-titanium (NiTi) files to reduce the risk of fractured instruments. After preparation, the root canals were filled using thermoplastified techniques. The 1-year follow-up periapical radiographs and CBCT images revealed a continuous periodontal space with no signs of apical periodontitis. KEY LEARNING POINTS • Cone beam computed tomography imaging is useful in identifying the root canal system and the surrounding structures. • An accurate detection of supernumerary roots, such as RE, can avoid complications during and after root canal treatment. • The analysis of root canal curvature is important because instrument fracture has been linked to angle and radius of curvature. • The use of new instruments can reduce the incidence of instrument fracture.
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Affiliation(s)
- F Abella
- Department of Endodontics, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Barcelona, Spain
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Zhang R, Wang H, Tian YY, Yu X, Hu T, Dummer PMH. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals. Int Endod J 2011; 44:990-9. [DOI: 10.1111/j.1365-2591.2011.01904.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Root Anatomy and Canal Configuration of the Permanent Mandibular First Molar: A Systematic Review. J Endod 2010; 36:1919-31. [DOI: 10.1016/j.joen.2010.08.055] [Citation(s) in RCA: 167] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 08/26/2010] [Accepted: 08/28/2010] [Indexed: 12/20/2022]
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Kottoor J, Sudha R, Velmurugan N. Middle distal canal of the mandibular first molar: a case report and literature review. Int Endod J 2010; 43:714-22. [PMID: 20491988 DOI: 10.1111/j.1365-2591.2010.01737.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To present a clinical case report in a mandibular first molar with a middle distal canal, along with a review of the literature. SUMMARY With the use of magnification, either by microscopes or by loupes, there is an increasing possibility of detecting additional canals. The present case describes root canal treatment in a mandibular first molar with two roots and a Sert and Bayirli Type XVIII canal configuration in the distal root. The presence of a three canals in the distal root of mandibular first molars has been reported to have an incidence of 0.2-3%. KEY LEARNING POINTS * Clinicians should be aware of the variable root canal anatomy in the distal root of mandibular first molars. * Use of magnification helps to identify and locate additional root canals. * Three root canals in the distal root of mandibular first molar teeth might occur.
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Affiliation(s)
- J Kottoor
- Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India.
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