Cone-beam computed tomographic analysis on root and canal morphology of mandibular first permanent molar among multiracial population in Western European population

ABSTRACT

Objective: In the present study, confluent canals in the mandibular first molar's mesial root were investigated in an Italian population by means of cone-beam computed tomography (CBCT). Materials and Methods: A total of 200 molars, selected from the CBCT examinations of 130 patients who required this type of X-ray study as part of their dental treatment, were examined. The evaluated parameters were number of canals, root canal system configuration, presence of apical confluences, distance between confluences and apical foramina, which canal had a higher degree of curvature, and symmetry between left and right elements in the same individual. Statistical Analysis Used: Percentages of the cases were reported. Results: All the examined roots presented two canals. In 59% of cases, a Vertucci Type IV canal configuration was observed, while in 41% of cases, a Type II configuration was observed. Apical confluences were present in 41% of cases. The average distance between confluences and apical foramina was 2.85 mm. When confluences were present, the mesiobuccal canal showed a higher degree of curvature in 78% of cases. Symmetry in Vertucci configuration was seen in 88% of cases. Conclusions: Apical confluences in the mesial roots of mandibular molar can be present in a significantly high number of cases, and their recognition is essential to prevent the iatrogenic errors during canal instrumentation.

Key words:

Anatomy - cone-beam computed tomography - endodontics - root canal treatment

• REFERENCES

• 1 Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Top 2005; 10: 3-29
• 2 Kim Y, Perinpanayagam H, Lee JK, Yoo YJ, Oh S, Gu Y. et al. Comparison of mandibular first molar mesial root canal morphology using micro-computed tomography and clearing technique. Acta Odontol Scand 2015; 73: 427-32
• 3 Lee KW, Kim Y, Perinpanayagam H, Lee JK, Yoo YJ, Lim SM. et al. Comparison of alternative image reformatting techniques in micro-computed tomography and tooth clearing for detailed canal morphology. J Endod 2014; 40: 417-22
• 4 Basrani B. Endodontic Radiology. 2nd ed.. Hoboken, New Jersey, US: Wiley-Blackwell; 2012
• 5 Gurtu A, Aggarwal A, Mohan S, Singhal A, Bansal R, Agnihotri K. CBCT: A revolutionary diagnostic aid for endodontic dilemmas. Minerva Stomatol 2014; 63: 325-31
• 6 Patel S, Dawood A, Whaites E, Pitt Ford T. New dimensions in endodontic imaging: Part 1. Conventional and alternative radiographic systems. Int Endod J 2009; 42: 447-62
• 7 Patel S. New dimensions in endodontic imaging: Part 2. Cone beam computed tomography. Int Endod J 2009; 42: 463-75
• 8 Ambu E, Ghiretti R, Laziosi R. 3D Radiology in Dentistry. Diagnosis Pre-Operative Planning Follow up. Milan, Italy: Elsevier; 2013
• 9 Scarfe WC, Farman AG. What is cone-beam CT and how does it work?. Dent Clin North Am 2008; 52: 707-30 v
• 10 Eder A, Kantor M, Nell A, Moser T, Gahleitner A, Schedle A. et al. Root canal system in the mesiobuccal root of the maxillary first molar: An in vitro comparison study of computed tomography and histology. Dentomaxillofac Radiol 2006; 35: 175-7
• 11 Scarfe WC, Levin MD, Gane D, Farman AG. Use of cone beam computed tomography in endodontics. Int J Dent 2009; 2009: 634567
• 12 Haridas H, Mohan A, Papisetti S, Ealla KK. Computed tomography: Will the slices reveal the truth. J Int Soc Prev Community Dent 2016; 6: S85-92
• 13 de Pablo OV, Estevez R, Péix Sánchez M, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: A systematic review. J Endod 2010; 36: 1919-31
• 14 de Pablo OV, Estevez R, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: Clinical implications and recommendations. Quintessence Int 2012; 43: 15-27
• 15 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
• 16 Tocci L, Plotino G, Grande NM, Testarelli L, Messineo D, Ciotti M. et al. Analysis of root and root canal morphology of maxillary and mandibular molars in a Caucasian population: CBCT study in vivo . G Ital Endodonzia 2013; 27: 13-20
• 17 Harris SP, Bowles WR, Fok A, McClanahan SB. An anatomic investigation of the mandibular first molar using micro-computed tomography. J Endod 2013; 39: 1374-8
• 18 Lee JK, Yoo YJ, Perinpanayagam H, Ha BH, Lim SM, Oh SR. et al. Three-dimensional modelling and concurrent measurements of root anatomy in mandibular first molar mesial roots using micro-computed tomography. Int Endod J 2015; 48: 380-9
• 19 Plotino G, Tocci L, Grande NM, Testarelli L, Messineo D, Ciotti M. et al. Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: A cone-beam computed tomography study in vivo . J Endod 2013; 39: 1545-8
• 20 Felsypremila G, Vinothkumar TS, Kandaswamy D. Anatomic symmetry of root and root canal morphology of posterior teeth in Indian subpopulation using cone beam computed tomography: A retrospective study. Eur J Dent 2015; 9: 500-7