Prevalence of C-shaped canal system in mandibular first and second molars in a Saudi population assessed via cone beam computed tomography: a retrospective study

Three-dimensional evaluation of root canal morphology in mandibular premolars of Saudi individuals: a CBCT study

In-depth knowledge of the anatomical structure of the root canal system is fundamental for successful endodontic treatment. This research aimed to evaluate the root canal structures of lower premolars in the Saudi western demographic via Cone Beam Computed Tomography (CBCT) scans. 760 CBCT scans were reviewed, which incorporated 2747 mandibular premolar teeth. SPSS was employed for descriptive statistics and Pearson chi-square tests. The Kappa tests were executed for intra- and inter-observer consistency. The number of roots, canals, and canal configurations based on Vertucci's classification were assessed. The study further explored the prevalence, patterns, and variations of the root canal systems, considering gender-based variations and bilateral resemblance. Predominantly, mandibular premolars possessed a single root, though a minority displayed two or three roots. The occurrence of multiple canals was also on the lower side, with the type I canal pattern emerging predominantly. Gender-based distinctions were evident, as males exhibited a higher frequency of two-rooted premolars and multiple canals than females. It was noted that the anatomical differences were more in the mandibular first premolars than in the second premolars. A significant bilateral consistency was observed, with most teeth showcasing consistent root and canal numbers. This research offers essential perspectives on the diverse nature and variability of root canal anatomy within the Saudi Western cohort, facilitating better understanding and treatment planning in endodontics.

Evaluation of root and canal morphology of mandibular molar teeth by cone beam computed tomography: cross-sectional study

OBJECTIVES

The objective of the research was to analyze the differences in root structure found in mandibular molars through cone beam computed tomography (CBCT) and to highlight their morphological features.

MATERIALS AND METHODS

This study retrospectively examined CBCT images of 200 patients, encompassing a total of 496 molars in the study group. The frequency of radix entomolaris (RE), radix paramolaris (RP), and C-shaped canals was assessed based on molar type, side, and gender. The data are presented as frequencies and percentages, and the Chi-square test was employed to analyze potential differences between groups. A significance level of p < 0.05 was set for all tests. The normality of the data was assessed using the Shapiro-Wilk test.

RESULTS

The study included 91 males (47%) and 109 females (53%), with a mean age of 32.49 ± 14.29 years. The frequency of RE was 4.2% (n = 21), RP was 0.8% (n = 4) and C-shaped canal was 7.1% (n = 35) in 496 molars (first molars n = 247, second molars n = 249). RE, RP and C-shaped canal were found in 3.4%, 0.2% and 0.2% of the mandibular first molars, respectively; RE, RP and C-shaped canal were found in 0.8%, 0.6% and 6.8% of the second molars, respectively. There was no statistically significant difference between the root variations examined and gender and lateralisation (p > 0.05).

CONCLUSIONS

Identifying anatomical variations in mandibular molars holds clinical importance, as it can improve endodontic treatment outcomes and provide insight into existing failures. Early detection of C-shaped canals and additional root structures can provide more effective cleaning and disinfection processes by more customizing treatment plans.

C-shaped root canal systems in the bilateral mandibular first molars: a case report and literature review

BACKGROUND

Mandibular first molars typically exhibit complex root and canal anatomy. A thorough understanding of their morphological variations is crucial for endodontists to achieve successful root canal treatment. A C-shaped root canal system is a unique anatomical variation characterized by a C-shaped or semi-circular cross-sectional morphology, observed predominantly in mandibular second molars. The prevalence rate of the C-shaped root canal system is approximately 2.7-48.7% in the mandibular second molar, while the condition is rarely seen in mandibular first molars, particularly in bilateral cases.

CASE PRESENTATION

This report details an uncommon case of a C-shaped root canal system in bilateral mandibular first molars: the right molar exhibited a fused root with two separate mesial and two distal canals, while the left molar displayed a single oval mesial canal and a semicolon-shaped distal canal. To our knowledge, this is the first report of the presence of four separate canals within a fused C-shaped root in the mandibular first molar.

CONCLUSIONS

While C-shaped root variations are detected in mandibular first molars, a thorough knowledge of normal root canal anatomy and associated variations presents a significant challenge for clinicians in terms of successful endodontic treatment.

C-shaped canal configuration in mandibular second molars of a selected Uyghur adults in Xinjiang: prevalence, correlation, and differences of root canal configuration using cone-beam computed tomography

OBJECTIVES

To determine the prevalence of C-shaped root canal system configurations and assess the correlation between C-shaped root canal prevalence and root morphology in mandibular second molars among adults in Xinjiang Uyghur population using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

CBCT imaging data from patients treated at the First Affiliated Hospital of Xinjiang Medical University (Affiliated Stomatology Hospital) were retrospectively analyzed. The prevalence of C-shaped root canal configurations in mandibular second molars was determined based on Fan et al.'s classification. Axial sections of each tooth were evaluated in the coronal, middle, and apical thirds to identify canal configurations and analyze root morphology. The differences in C-shaped canal prevalence between genders and tooth positions were compared. Statistical analysis was performed using the chi-square test (p < 0.05).

RESULTS

A total of 1748 patients were included, with 510 (29.17%) exhibiting C-shaped root canals. Females exhibited a higher prevalence (31.49%) than males (25.15%). C-shaped canals were more frequently observed on the lingual surface (76.8%) than the buccal surface (22.2%). Bilateral symmetry of C-shaped canals was observed in 64.7% of cases. A significant association was found between C-shaped canals and root morphology (p < 0.001). Among patients with C-shaped canals, 66.9% demonstrated symmetrical configurations. The most common configuration was C3 (present in all axial levels), followed by C1 and C2. Mandibular second molars with three roots or type 3/type 4 morphologies exhibited a high probability of C-shaped canals.

CONCLUSIONS

C-shaped canals were more prevalent in females and lingually positioned in mandibular second molars. Bilateral C-shaped canals were frequently symmetrical and more common than unilateral cases. Mandibular second molars with three-root or type 3/type 4 morphologies may indicate a high likelihood of C-shaped canals. The most common configuration was C3, followed by C1 and C2, all present across all axial levels. Understanding these anatomical variations preoperatively can improve clinical management.

Anatomical features of mandibular second molar C-shaped root canals in a Chinese population: a CBCT analysis

PURPOSE

C-shaped root morphology features narrow canals, root concavity, and thin dentinal walls, necessitating careful treatment planning and clinical expertise for effective cleaning and shaping.

METHODS

This study included 401 total CBCT images of mandibular second molars with C-shaped root canals. Root morphology, root length, dentin thickness, and the location, length, width, and depth of the radicular groove were all analyzed with the Planmeca Romexis 3.1.0.R software. Fan Bing's C-shaped root canal classification method was used to classify all data, and SPSS was used for statistical analyses.

RESULTS

These analyses revealed significant differences in radicular groove for mandibular second molars with C-shaped root canals across different root canal cross-sections. The mean respective root and radicular groove lengths for the analyzed molars were 11.64 ± 1.42 mm, and 9.34 ± 1.42 mm, and coronal, middle, and apical radicular groove incidence rates were 94.51%, 100%, and 98.75% respectively. The observed radicular grooves were widest at the coronal level and deepest at the middle level, while dentin was thinnest at the apical level.

CONCLUSIONS

This study offers an overview of the radicular groove characteristics in mandibular second molars with C-shaped root canals, providing anatomical data to assist clinicians in root canal treatment.

Prevalence and Morphology of C-Shaped Canals in Mandibular Second Molars: A Cross-Sectional Cone Beam Computed Tomography Study in an Ecuadorian Population

Background/Objectives: C-shaped canals represent a challenge in endodontic procedures. The present study aimed to investigate the prevalence and characteristics of C-shaped canals in mandibular second molars in Guayaquil, Ecuador. Methods: CBCT records from two radiology centers were examined (2020-2022). A total of 400 CBCT scans (800 mandibular second molars) were analyzed using Fan's classification. Data on the presence or absence of C-shaped canals, gender, and bilateral occurrence were collected. Statistical analysis included the test for differences in proportions and the chi-squared test to assess the significance of correlations between variables. Results: C-shaped canals were found in 28% of mandibular second molars, affecting 33.75% of the patient sample. The prevalence was significantly higher in females (42.9%) compared to males (20.4%). Bilateral occurrences were observed in 63% of affected patients. Morphologic variability was pronounced, with Fan C1 and C4 dominating in the coronal and apical thirds, respectively, while a shift toward Fan C2 and C3 was observed in the middle third. Only 19.2% of the teeth maintained a consistent morphology. Conclusions: C-shaped canals were found in 28% of mandibular second molars and occurred predominantly in females. Notably, most cases were bilateral, highlighting the importance of effectively adapting endodontic techniques to treat this unique anatomical variation. Further research into genetic and environmental influences could deepen our understanding and help develop refined diagnostic and therapeutic strategies.

Evaluation of mandibular and maxillary second molar root canal anatomy in a Turkish subpopulation using CBCT: comparison of Briseno-Marroquin and Vertucci classifications

BACKGROUND

This retrospective study aims to characterise the root canal morphology of maxillary and mandibular second molars using cone-beam computed tomography (CBCT). The number of roots and canal configurations were evaluated using both the Vertucci and Benjamı´n Brisen˜ o Marroquı´n classification systems.

METHODS

A total of 1084 second molar images (523 maxillary; 266 right and 257 left side and 561 mandibular; 285 right and 276 left side) were evaluated from 320 CBCT scans analyzed for the Turkish subpopulation. CBCT imaging provided superior visualisation of root canal anatomy compared to periapical radiography. The findings revealed diverse root canal configurations, with variations observed even within the same population. Statistical analyses, including the chi-squared test, were used to assess correlations between root number and demographic variables such as age and sex.

RESULTS

According to Benjamı´n Brisen˜ o Marroquı´n classification system, the most common configuration for upper right three-rooted teeth mesial root was 3URM2-1 (n:66, 35.7%), for distal root was 3URM1 (n:169, 91.4%), and for palatal root was 3URM1 (n:165, 89.2%). Additionally, the most common configuration for upper left three-rooted teeth mesial root was 3271 (n:50, 28.4%), for distal root was 3ULM1 (n:160, 90.9%), and for palatal root was 3ULM1 (n:158, 89.8%). In lower left molars, the most common configuration in the two-rooted teeth mesial root was 2LLM2 (n:114, 49.4%), and for the distal root was 2LLM1 (n:170, 73.6%). For lower right the most common configuration for two-rooted teeth mesial root was 2LRM2 (n:125, 52.5%), and for distal root was 2LRM1 (n:173, 72.7%)(p < 0.05).

CONCLUSION

The primary outcome was observed that the root canal anatomy of upper and lower second molars may differ in both classifications of Turkish subpopulation. While Vertucci's classification was inadequate in some cases, Briseno-Marroquin classification was able to classify all upper and lower second molars with a single code. This new classification is a more useful system for classifying all second molars. There is a statistically significant difference exists among the new configuration according to the distribution of the teeth analyzed.

Assessment of the root and canal morphology in the permanent dentition of Saudi Arabian population using cone beam computed and micro-computed tomography - a systematic review

INTRODUCTION

Root canal treatment procedures require a thorough understanding of root and canal anatomy. The purpose of this systematic review was to examine the morphological differences of teeth root and their canals assessed using cone-beam computed and micro-computed tomography in Saudi Arabian population.

METHODOLOGY

An electronic search was conducted in PubMed / Medline, Scopus, Google Scholar, and Web of Science databases until January 2023 to retrieve related studies. "Root canal morphology," "Saudi Arabia," "Micro-CT," and "cone-beam computed tomography" were used as keywords. A modified version of previously published risk of bias assessment tool was used to determine the quality assessment of included studies.

RESULTS

The literature search revealed 47 studies that matched the criteria for inclusion, out of which 44 studies used cone beam computed tomography (CBCT) and three were micro-computed tomography (micro-CT) studies. According to the modified version of risk of bias assessment tool, the studies were categorized as low, moderate, and high risk of bias. A total of 47,612 samples were included which comprised of either maxillary teeth (5,412), or mandibular teeth (20,572), and mixed teeth (21,327). 265 samples were used in micro-CT studies while 47,347 teeth samples were used in CBCT studies. Among the CBCT studies, except for three, all the studies were retrospective studies. Frequently used imaging machine and software were 3D Accuitomo 170 and Morita's i-Dixel 3D imaging software respectively. Minimum and maximum voxel sizes were 75 and 300 μm, Vertucci's classification was mostly used to classify the root canal morphology of the teeth. The included micro-CT studies were in-vitro studies where SkyScan 1172 X-ray scanner was the imaging machine with pixel size ranging between 13.4 and 27.4 μm. Vertucci, Ahmed et al. and Pomeranz et al. classifications were applied to classify the root canal morphology.

CONCLUSION

This systematic review revealed wide variations in root and canal morphology of Saudi population using high resolution imaging techniques. Clinicians should be aware of the common and unusual root and canal anatomy before commencing root canal treatment. Future micro-CT studies are needed to provide additional qualitative and quantitative data presentations.

Prevalence and Morphology of C-Shaped Canals in Mandibular First and Second Molars of an Iranian Population: A Cone-Beam Computed Tomography Assessment

Objectives

The complex anatomy of C-shaped canals poses challenges for clinicians compared to teeth with normal root canal anatomy. This study is aimed at evaluating the frequency and morphology of C-shaped canals in the mandibular first and second molars among an Iranian population using cone-beam computed tomography (CBCT).

Materials and Methods

This cross-sectional study evaluated 369 CBCT scans from the archives of a radiology clinic in Ardabil, Iran. The sample included 248 mandibular first molars and 478 mandibular second molars. The presence of C-shaped canals and their classification, according to Fan et al., were evaluated at four levels: orifice, coronal, middle, and apical. Prevalence based on gender and tooth type was also assessed.

Results

A total of 199 (53.9%) males and 170 (46.1%) females were evaluated. C-shaped canals were found in 11 (8 males/3 females) out of 248 (4.4%) first molars and in 20 (11 males/9 females) out of 478 (3.7%) second molars. The C2 configuration was most prevalent in the orifice, coronal, and middle levels of both molar types, while C3 and C4 morphologies were most commonly found apically in the second and first molars, respectively. A significant difference in configuration was found only at the coronal level between molar types. A significant association between gender and configuration was observed only at the orifice level of the second molars. No other significant differences were found (P > 0.05).

Conclusion

C-shaped canal configurations should be expected in 4.4% of mandibular first molars and 3.7% of the second molars in this Iranian population, with a predominance of the C2 configuration in the orifice, coronal, and middle levels.

Prevalence of C-shaped canals and three-rooted mandibular molars in the Iranian population by using cone-beam computed tomography

OBJECTIVES

This study aimed to evaluate the prevalence of C-shaped canals and three-rooted mandibular molars in the Iranian population using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

This study evaluated mandibular teeth on 292 CBCT scans of patients referred to the Department of Radiology, Faculty of Dentistry, Islamic Azad University, Isfahan, Iran. All CBCT scans were obtained with the same three-dimensional CBCT scanner, and sections were reconstructed in all three planes (sagittal, axial, and coronal) with 1 mm slice thickness. A total of 291,402, and 200 first, second, and third molars, respectively, were evaluated. Data were analyzed using SPSS software (version 26.0).

RESULTS

Of 291 mandibular first molars, 0.7% were single-rooted, 96.6% were two-rooted, and 2.7% were three-rooted. The prevalence of C-shaped canals was 1.7% in mandibular first molars. Of 402 mandibular second molars, 8.5% were single-rooted, 90.5% were two-rooted, and 1% were three-rooted. The prevalence of C-shaped canals was 2% in mandibular second molars. Of 200 mandibular third molars, 21.5% were single-rooted, 77.5% were two-rooted, and 1% were three-rooted. The prevalence of C-shaped canals was 2% in mandibular third molars.

CONCLUSION

In the present study, the majority of mandibular molars were two-rooted, and three-rooted mandibular molars were less common. The third and second mandibular molars both had an increased prevalence of C-shaped canals. Mandibular first molars had the highest prevalence of three-rooted molars.

CBCT and Micro-CT analysis of the mandibular first premolars with C-shaped canal system in a Chinese population author

OBJECTIVES

The purpose of this study was to survey the prevalence of C-shaped root canal system in mandibular first premolar in Chinese population by reading Cone-beam computed tomography (CBCT) images and to analyze its anatomical characteristics by CBCT and Micro-computed tomography (Micro-CT).

METHODS AND MATERIALS

The prevalence and the morphologic features of C-shaped root canal system were evaluated by observing CBCT images of 760 patients (1520 mandibular first premolars). 66 mandibular first premolars with C-shaped root canal system were scanned by Micro-CT. The morphologic features including radicular groove, C-shaped root canal categories in the cross-sections and in the 3D models, accessory and connecting canals, apical foramina and accessory foramina, were analyzed using image software.

RESULTS

C-shaped root canal system was identified in 16.9% of mandibular first premolars. The minimum mesial wall thickness most commonly occurred at the lingual site (69.7%). Regarding to the cross-sectional classification, the maximum was C2 (41.5%). In the 3D classification, the most common was S (34.8%). Accessory canals were observed in 36.4% of the samples and occurred mostly in the middle and apical regions. 42.4% samples had 1-3 variable connecting canals, and 40.9% samples had only one apical foramen.

CONCLUSIONS

The incidence of C-shaped root canal system in mandibular first premolars was 16.9% in the Chinese population. The anatomy was very complex and variable, mostly distributed in the middle and apical regions of the root canal. The mesial wall of C-shaped canal was extremely thin on the lingual side.

Root and canal morphology of mandibular second molars in an Egyptian subpopulation: a cone-beam computed tomography study

BACKGROUND

This study was using Cone beam computed tomography (CBCT) to examine the anatomical variations in mandibular second molars in an Egyptian sub-population.

METHODS

A total of 350 CBCT images (215 females and 135 males, aged 15-65 years) of mandibular second molars were evaluated. Samples were evaluated in terms of: number of roots, number of root canals, roots' cross section as well as prevalence and configurations of C-shaped canals. Statistical analysis was done to highlight differences between different categories and their prevalence among genders (significance level was set at p < 0.05). Data were presented as frequency and percentage values and were analyzed using chi square test followed by pairwise comparisons utilizing multiple Fisher's exact tests with Bonferroni correction. The significance level was set at p < 0.05 within all tests.

RESULTS

Of the 350 mandibular second molars evaluated, 87.2% were non-C-shaped while 12.8% were C-shaped with no gender-based statistically significant differences (χ2 = 0.19, p = 0.656). Most samples had three root canals (80%) followed by two (16%), then one (3.2%), and finally four (0.8%) root canals. Among the non-C-shaped molars, presence of two roots was most common (83.4%) followed by presence of a single root (16.2%), and only one sample (0.2%) had three roots, and this had no correlation with gender (χ2 = 1.86, p = 0.431). In the mesial roots Type IV Vertucci was the most common configuration found (68.8%), while Type I was the most prevalent in the distal roots (91.8%). The long oval configuration was the most commonly found cross section in mesial roots while "oval" was the most prevalent in distal roots.

CONCLUSION

Egyptian sub-population shows highly variable morphological features in mandibular second molars, hence, CBCT is highly recommended on case-to-case conditions.

Prevalence and correlation of C-shaped root canals of mandibular premolars and molars in Eastern Chinese individuals

The aim of this study was to investigate the prevalence, correlation, and differences of C-shaped root canals (CSRCs) morphology in permanent mandibular premolars and molars in Eastern Chinese individuals using cone-beam computed tomography (CBCT). A total of 8000 mandibular first premolars (MFPs), mandibular second premolars (MSPs), mandibular first molars (MFMs), and mandibular second molars (MSMs) CBCT images from 1000 patients (692 females and 308 males) were collected. The prevalence, correlation, bilateral/unilateral presence, the morphology of CSRCs, level of canal bifurcation, gender differences, and location of radicular grooves (RGs) were evaluated. The prevalence of CSRCs in MFPs, MSPs, MFMs and MSMs were 10.25%, 0.25%, 0.55% and 47.05%, respectively. The prevalence of CSRCs in MFPs of males was higher than that in females, while the prevalence of CSRCs in MSMs of females was higher than that in males (P < 0.05). The bilateral symmetry presence of CSRCs in MSMs was significant but not in MFPs, MSPs, and MFMs. RGs were predominantly found on the mesiolingual (ML) surface of premolars and the lingual surface of molars. There was a high prevalence of CSRCs in MFPs and MSMs in the Eastern Chinese population, but there was no correlation. The prevalence of CSRCs in MFPs and MSMs differ significantly by gender (P < 0.05).

A lightweight convolutional neural network model with receptive field block for C-shaped root canal detection in mandibular second molars

Rapid and accurate detection of a C-shaped root canal on mandibular second molars can assist dentists in diagnosis and treatment. Oral panoramic radiography is one of the most effective methods of determining the root canal of teeth. There are already some traditional methods based on deep learning to learn the characteristics of C-shaped root canal tooth images. However, previous studies have shown that the accuracy of detecting the C-shaped root canal still needs to be improved. And it is not suitable for implementing these network structures with limited hardware resources. In this paper, a new lightweight convolutional neural network is designed, which combined with receptive field block (RFB) for optimizing feature extraction. In order to optimize the hardware resource requirements of the model, a lightweight, multi-branch, convolutional neural network model was developed in this study. To improve the feature extraction ability of the model for C-shaped root canal tooth images, RFB has been merged with this model. RFB has achieved excellent results in target detection and classification. In the multiscale receptive field block, some small convolution kernels are used to replace the large convolution kernels, which allows the model to extract detailed features and reduce the computational complexity. Finally, the accuracy and area under receiver operating characteristics curve (AUC) values of C-shaped root canals on the image data of our mandibular second molars were 0.9838 and 0.996, respectively. The results show that the deep learning model proposed in this paper is more accurate and has lower computational complexity than many other similar studies. In addition, score-weighted class activation maps (Score-CAM) were generated to localize the internal structure that contributed to the predictions.

A CBCT based cross sectional study on the prevalence and anatomical feature of C shaped molar among Jordanian

The prevalence and anatomical features of C-Shaped Mandibular Second Molars (MSMs) are rarely studied in Jordanian sub-population. This study then took a part to evaluate the prevalence of C-shaped in MSMs using cone-beam computed tomography (CBCT) in the Jordanian sub-population. It used a cross-sectional design and three thousand scans collected over eight years between 2011 and 2019. The data were then reviewed for whether they were fully formed of MSMs. A total of 2037 cases that had 2845 MSMs were evaluated to identify C-shaped canals at coronal, middle, and apical sites. An oblique slicing module perpendicular to the long axis of MSMs was used to evaluate the teeth. The type and frequency of C-shaped canals, as well as the correlations between sex and side (right/left) and between sex and groove direction (buccal/lingual) were measured using the chi-square test on SPSS software at the significance level of 95%. A total of 342 teeth of 243 patients were C-shaped molars, which comprised 12% of the patient's teeth and 99 of them as a bilateral C-shaped canal with mean age of 40 years and sex ratio of 2:1 between female and male. With the limitations of this study, the lingual groove and type 3 were the most common properties of MSM. Besides, the Jordanian population mostly had C-shaped canals.

Anatomical Evaluation of Root and Root Canal Morphology of Permanent Mandibular Dentition among the Saudi Arabian Population: A Systematic Review

This study aimed to conduct a compendious review of root canal morphology of “permanent mandibular teeth in different regions of Saudi Arabia” to obtain a large sample representing the total population. A detailed search through the databases Web of Science, Scopus, and PubMed was conducted following the PRISMA guidelines. The data were analyzed based on the following inclusion criteria: original full-length original articles that reported the variables of interest “(number of roots, number of canals, Vertucci's classification system and C-shaped canals or mid-mesial canals)” of the mandibular teeth and conducted on Saudi subjects. The retrieved data were presented as frequencies and percentages. The results revealed that 56.6% of mandibular central incisors had one canal and Vertucci type I (56.6%), while 57.4% of the mandibular lateral incisors had one canal, with Vertucci types I and III most frequent. In mandibular canines, 91.8% had one canal and 8.2% had two canals. Most of the mandibular first premolars had one root (86.6%), while almost all mandibular second premolars (91.5%) had one canal, and 96.9% had Vertucci type I configuration. Among the mandibular first molars, three and four canals were prevalent in 58.7% and 40.6%, respectively. The majority of mesial roots had Vertucci type IV (60.6%), and most of distal roots had Vertucci type I (72.2%). Most of the mandibular second molars had three canals (87.3%) and showed Vertucci type IV (39.4%) canals for mesial roots and Vertucci type I (95.6%) for distal roots. The C-shaped canals were seen in 8% of first premolars and 9.8% of second molars. The middle mesial canal was found in 4.2% and 0.4% of first and second molars, respectively. This review could represent “the population of Saudi Arabia as the included samples were combined from different regions of the country.” Some variations were noticed within the same group of teeth from different regions. However, the overall results of combined samples were comparable to the other international studies.

Variations of root and canal morphology of mandibular second molars in Chinese individuals: a cone-beam computed tomography study

BACKGROUND

The mandibular second molars demonstrate variations on root and canal morphology. The aim of this study was to investigate all the root canal morphology of mandibular second molars and analyze the morphological variations in patients by gender and age in a Chinese population use CBCT imaging.

METHODS

Cone-beam computed tomographic images of 1200 bilateral mandibular second molars were obtained from 600 patients (300 females and 300 males) who required a preoperative assessment for implant surgery, surgical removal of impacted teeth, orthodontic treatment, surgery of maxillofacial tumour and cysts or LeFort I osteotomy. CBCT images were divided into 5 groups according to age: "15-24 years", "25-34 years", "35-44 years", "45-54 years" and "≥ 55 years"; and 2 groups by gender: "females" and "males". The following information were recorded: the number of roots and canals and their morphology, the frequency and configuration of C-shaped canals by gender, age and position (left and right). The chi-square test was used to analyse differences between groups. P value of < 0.05 was considered statistically significant.

RESULTS

Of the 1200 teeth, 61% had two separate roots located mesiodistally, 35.6% had one C-shaped root. The 45.3% teeth had three canals in two-rooted mandibular second molars. The mesial root showed a Vertucci type II configuration in 28.9% cases followed by type IV(24.4%). While the distal root showed a significant higher prevalence of type I configuration in 95.6%. In the examined 1200 teeth, 430 teeth (35.8%) had C-shaped root canals. The prevalence of C-shaped root canal systems was significantly higher in females (42.5%) than in males (29.1%) (P = 0.000), and did not differ with age (P = 0.126). The 80.4% C-shaped canals were bilateral (P = 0.000) and did not differ with side (left and right) (P = 0.758).

CONCLUSIONS

The most commonly observed root morphology for the mandibular second molars was 2 separate roots with three canals.The prevalence of C-shaped root canal is 35.8% and is more higher in females than in males.

Comprehensive evaluation of root and root canal morphology of mandibular second molars in a Saudi subpopulation evaluated by cone-beam computed tomography

BACKGROUND

The study's goal was to use Cone Beam Computed Tomography (CBCT) to assess the root and root canal anatomy of mandibular second molars with C-shaped root canal configurations in residents of the Hail district. The impact of gender and side on the frequency of root canal morphology was considered.

METHODS

The sample size for this study was 304 untreated mandibular second molars with completely developed roots on the right and left sides. Using CBCT on the teeth, the root form and canal morphology for each root are based on Vertucci's classification. The occurrence of canals in the shape of a C. The prevalence and resemblance of the left and right sides or men and females were investigated. The Chi-square test was performed to evaluate the findings.

RESULTS

Of the 304 mandibular second molars studied, 286 teeth had two roots (94.1%), whilst 13 (4.3%) were C-shaped root canal systems. 77 molars (25.3%) had two canal orifices, 219 (72.0%) had three canal orifices, and six (2.0%) and one (0.3%) had four and five root canal orifices, respectively. Type IV was the most common for mesial root, accounting for 57.7% of the sample (n = 176). For distal root, the most common occurrence was type I, which occurred 282 times (96.60%). The most prevalent root canal morphology was the presence of two canals in the mesial root and one canal in the distal root of teeth with two distinct roots (variant 3). (69.4%). The overall prevalence of C-shaped root canal systems is (4.3%) (n = 13).

CONCLUSIONS

The patient's race is an undeniable factor that influences root canal anatomy. The root canal morphology of mandibular second molars revealed significant differences between Saudi subpopulations. The majority of mandibular second molars had two roots and three root canals. When treating these molars, the presence of a C-shaped root canal system must be taken into account.

Radiographic Investigation of Root Canal Morphology of Permanent Mandibular Molars in Makkah Population (Saudi Arabia) Using Cone-Beam Computed Tomography

Objectives

This study aimed to analyze the root canal morphology of first and second permanent mandibular molars among Makkah population by using cone-beam computed tomography (CBCT).

Materials and Methods

CBCT images of two hundred eight patients were obtained from the Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia. In all images, mandibular first and second molars were evaluated for the number of roots and their morphology, number of root canals, canal configuration in each root according to Vertucci's classification, and the presence of a C-shaped canal.

Results

Most of the mandibular first molars had two roots (96.5%) and three root canals (77.7%). Type IV canal configuration prevailed (75.6%) in the mesial roots, and type I canal configuration prevailed (71.7%) in the distal roots. For the mandibular second molars, the majority had two roots (96.3%) and three root canals (82.7%). Type IV canal configuration prevailed (48%) in the mesial roots and type I (99.1%) in the distal roots. C-shaped canals were detected in 5.7% of the mandibular first molars and 4% of the mandibular second molars. There was no statistical difference between the mandibular first and second molars (P > 0.05) in the shape of the roots and the presence of the C-shaped canals.

Conclusion

Most of the mandibular molars in Makkah population presented with two roots and three root canals. The incidence of three-rooted mandibular molars was low, and it was higher in the first molars than second molars. The type IV root canal system prevailed in mesial roots and type I in distal roots.

Evaluation of C-shaped canals in maxillary molars in a Chinese population using CBCT

Introduction

The aim of this study was to evaluate the prevalence and characteristics of C-shaped root canals in maxillary first (MFMs) and second (MSMs) molars in a Southwestern Chinese population using cone-beam computed tomographic (CBCT).

Methods

CBCT images of MFMs (n = 1488) and MSMs (n = 1547) from 1508 subjects enrolled in Guiyang Hospital of Stomatology between July 2018 to February 2021 were evaluated for the incidence and types of C-shaped root canals. Differences by age, sex, left or right side, and bilateral symmetry were also evaluated.

Results

C-shaped root canals were present in 2.93% MFMs and MSMs (n = 3035) in the Southwestern Chinese population. A significant higher incidence was observed in the MSMs (5.24%) than in the MFMs (0.54%). Increased incidences were noted in teeth with fused root. Two major types and 5 subtypes of C-shaped canal system of maxillary molars were defined, and the most common type of C-shaped canals is fusion of mesial-buccal (MB) and distal-buccal (DB) canals (Type I subtype C). No significant gender and age differences were noted in the prevalence of C-shaped root canals in this population, and no significant difference was seen in its incidence in the left or right MFMs and MSMs. The bilateral occurrence was observed in 1.27% of the patients.

Conclusion

C-shaped root canals are more frequently present in MSMs than in MFMs in the Southwestern Chinese population, with Type I subtype C (MB-DB canal fusion) as the most common subtype and low incidence of bilateral symmetry.

The C-shaped Canal System in Mandibular Molars of a Saudi Arabian Population: Prevalence and Root Canal Configurations Using Cone-Beam Computed Tomography

OBJECTIVES

This retrospective study aimed to assess the prevalence of the C-shaped canal system in mandibular first and second molars in a Saudi Arabian population using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

The sample included 300 CBCT images from adults aged 18 to 80 years (38.7 ± 17.9) (150 females and 150 males). All images were analyzed to detect the C-shaped root canal according to Fan's criteria. We also categorized our findings according to the gender and direction of the longitudinal groove. Data were reported as frequencies and percentages. The Chi-squared test was used to analyze proportional differences, with the significance level set at ≤0.05.

RESULTS

The C-shaped canals were observed in 146 mandibular first molars (24.33%) and 182 second molars (30.33%). Male patients had a significantly higher prevalence of C-shaped canals in mandibular second molars than females (P=0.003). The longitudinal groove was most typically detected on the root's lingual surface (53.35%).

CONCLUSION

The incidence of the C-shaped canal in a Saudi Arabian population was 27.33% in the mandibular molars. The longitudinal groove was mostly on the lingual surface. Males showed a higher prevalence of the C-shaped canal than females.

The C-shaped root canal systems in mandibular second molars in an Emirati population

Our study aimed to describe the root and canal morphology of mandibular second molars in Emirati population and to study the prevalence and types of morphological change in C-shaped canal configuration along the root length in an effort to describe C-shaped molars as a unit. Cone beam computed tomography (CBCT) scans of Emirati patients were analyzed in multiple plans and root and canal configuration of mandibular second molars were evaluated. Moreover, specific types of morphological change in C-shaped canal configuration along root length were studied and reconstructed using 3D reconstruction software. A total of 508 mandibular second molars were evaluated. Among the non-C-shaped mandibular second molars, two separate roots were the most prevalent root morphology (78.3%). The mesial root's most common root canal configuration was Vertucci Type II (46.5%), and in the distal root, Vertucci Type I (90.5%). The prevalence of C-shaped mandibular second molars was 17.9% and was significantly prevalent (P < 0.001) in females. Specific types of morphological change in C-shaped molars along the root length were observed and described for the first time, in which the most common types of morphological change were C1-C2-C3d (18%), C1-C3c-C3d (15.4%), C4-C3c-C3d (7.7%), and C3c-C3c-C3d (7.7%). This study showed wide variations in the root and canal morphology in mandibular second molars in Emirati population with a relatively high prevalence of C-shaped canal configuration (17.9%). Moreover, specific types of morphological change in C-shaped configuration were detected and described for the first time in this population.

Evaluation of C-shaped canals in mandibular second molars of a selected patient group using cone beam computed tomography: prevalence, configuration and radicular groove types

The aim of the present study was to examine the prevalence, symmetry and configurations of C-shaped canals and radicular groove types in mandibular second molars according to age and sex in a Turkish sub-population using cone beam computed tomography (CBCT). In total, 674 CBCT images (368 females and 306 males, aged 18-76 years) of 1348 mandibular second molars were evaluated. The symmetry, configuration of C-shaped root canals, radicular groove types with age and sex were noted. One sample chi-square test and chi-square test were used to determine statistically significant differences. The statistical significance level was set at p < 0.05. Of the 1348 mandibular second molars evaluated, 10.7% had C-shaped root canals. C-shaped root canals appeared to be significantly more common in females than in males (p < 0.05). C1 (44.4%) was the most frequent configuration in the coronal third, and C2 (44.4%), and C4 (31.9%) were the most frequent configurations in middle and apical thirds, respectively. Type 2 (45.1%) was the most common radicular groove type (p < 0.05). The frequency of C-shaped root canals in mandibular second molars in a Turkish sub-population was considerably high (10.7%). CBCT can aid the detection of C-shaped canals and their configurations. Dentists should consider the possibility of C-shaped canals in root canal treatment of mandibular second molars, as these configurations have implications for biomechanical preparation and filling methods.

Root canal morphology and symmetry of mandibular second premolars using cone-beam computed tomography

OBJECTIVES

The current study aims to investigate the morphology and symmetry of root canals of mandibular second premolar teeth via Cone-Beam Computed Tomography (CBCT) among a sample of the Saudi population.

METHODS

A total of 1200 CBCT images were examined in the study. The number of roots in the mandibular second premolars was identified, and canal configurations were classified according to Vertucci classification. Bilateral symmetry and association between gender and number of roots and root canal configuration were investigated using a chi-square test was utilized for data analysis and p value was set at 0.05 for significance.

RESULTS

Of the total 2400 Mandibular second premolars, 98.33% were single rooted and 1.67% were double rooted. The prevalence of double roots in females on the right side was significantly higher than that on the left side (p = 0.017), but the opposite was found among males. Only Type I and II canal configurations showed significant differences regarding gender and sides. 98.0% of teeth showed the symmetrical number of roots in both genders. The symmetry in canal configuration was 96.7% in males and 97.3% in females and 99.1% was Type I in both sides, 0.5% Type III, and 0.3% Type IV in both sides.

CONCLUSIONS

The root morphology of mandibular second premolars in the Saudi population demonstrated a high degree of variability. The vast majority of mandibular premolars have a single root with one canal and a low prevalence of two rooted teeth. Contralateral mandibular second premolars exhibited great symmetry of roots and root canal configuration.

Anatomical Evaluation of Mandibular Molars in a Saudi Population: An In Vivo Cone-Beam Computed Tomography Study

Objective

This study assessed the canal configuration of mandibular molars according to Vertucci's classification of a Saudi population using cone-beam computed tomography (CBCT).

Methods

A total of 290 first and 367 second mandibular molars were analyzed. The CBCT images were evaluated in three sections to inspect the number of roots and canals and canal system. The data are presented as frequencies and percentages. The chi-squared test was used to assess differences between both sides. SPSS was used for analysis, with a significance level of α ≤ 0.05.

Results

Among the first molars, 95.4% of the teeth had two roots, and 64.5% had three canals. Approximately 57.9% showed Vertucci type IV mesial roots. Between the second molars, 89.6% of teeth had two roots and 80.4% had three canals. The frequency of Vertucci type IV (39.4%) was the highest in mesial roots. The first molars showed a high prevalence of 3-rooted teeth (5.5%). Both the right and left sides showed teeth with similar external and internal anatomy (p < 0.05).

Conclusion

Most of the mandibular first and second molars had two roots and three canals. In the first mandibular molars, similar to the second mandibular molars, the majority of the mesial canals had Vertucci type IV, while the distal canals had Vertucci type I.

Morphological variations of mandibular first premolar on cone-beam computed tomography in a Saudi Arabian sub-population

In-depth knowledge of common and aberrant pulp morphology is essential for appropriate diagnosis and treatment planning prior to commencing root canal treatment. Radicular morphology of mandibular premolars has been extensively studied. Considerable variation in the number of canals and roots found in these teeth has been reported.

Aim

The purpose of this study is to investigate the root and root canal morphology of mandibular first premolar among Saudi Arabian subpopulation in Aseer using CBCT.

Methods

Cone-beam computed tomography images of Mandibular first premolar were taken from 166 patients which were referred to Armed Forces Hospitals Southern Region (AFHSR), Khamis Mushayt, Asir region Saudi Arabia. All the images were assessed by two Evaluators (An Endodontist and a Radiologist). Inter-examiner reliability was determined and was assessed by KAPPA value.

Results

The mandibular first premolar (n = 216) distributed as 120 teeth in female and 96 teeth in male. Out of the 120 teeth examined in female groups one canal was seen in 95 (79.2%) teeth, two canals in 19 (15.8%) teeth and three canals in 6 (5%) teeth where as in the Male group out of 96 teeth, 52 (54.1%) teeth showed one canal, 32 (33.3%) teeth with two canals whereas 12 (12.5%) teeth showed presence of three canals.

Chi-Square test for mandibular first premolars demonstrated the chance of second canal in the mandibular first premolar more in male than female and these differences was statistically significant (P ≤ 0.05).

Conclusion

Endodontic therapy of mandibular premolars is a challenge for clinician because of their frequent morphological and anatomical abnormalities. Proper knowledge about number of root canals and canal configuration is a key to success in Endodontic. There is a great variability in different population regarding the root canal configuration in mandibular pre-molars. However, most studies state the mandibular first premolar has one root canal. Also, the most prevalent type of root canal found was Type I vertucci.

Print and Try Technique: 3D-Printing of Teeth with Complex Anatomy a Novel Endodontic Approach

The purpose of this report is to evaluate the applicability of a novel Print and Try technique in the presence of aberrant endodontic anatomies and to achieve a predictable treatment with improved outcome. According to guidelines, cone beam computed tomography (CBCT) is recommended in the presence of complex anatomies. The volumes were utilized to produce a stereo lithographic (STL) file, from which a 3D-plastic tooth model including a hollow root canal system was obtained. The 3D-patient-specific model facilitates the treatment planning and the trial of therapeutic approaches. Using a transparent material, all the treatment steps could be directly visualized. Subsequently, endodontic therapy could be performed in vivo with reduced operating time and with a better overview. Clinicians benefit from the Print and Try technique when facing a complicated root canal system with reduced stress and higher chances of success. In aberrant endodontic anatomies, the use of a transparent 3D plastic model, derived from the CBCT dicom, provides an exact preview of clinical challenges that will be met intra-operatively. A patient centered tailored approach to shaping, cleaning, and filling strategies can be applied.

Root and Canal Morphology of Mandibular Second Molars in a Yemeni Population: A Cone-beam Computed Tomography

Objective:

This study aimed to identify and characterize root and canal morphology and the prevalence of C-shaped canals of mandibular second molars (MSMs) in a Yemeni population using cone-beam computed tomography (CBCT).

Methods:

Three-dimensional digital images of 500 MSMs with mature roots were taken from 250 Yemeni individuals and analyzed for the following features: number of roots, shape and type of roots, type of canal configuration in each root, prevalence of C-shaped canal, and primary variations in the morphology of root and canal systems. Chi square and Fisher’s exact tests were employed for statistical analysis.

Results:

89.6% of MSMs had two separate roots, 9% had two fused roots, 0.6% had three separate roots and 0.8% had one root. Mesial root was mostly ribbon-shaped (60.5%) and distal root was mostly kidney-shaped (50.7%). Type II and Type I canal configurations were the most frequent in mesial (56.9%) and distal (91.3%) roots, respectively. C-shaped canals were found in 9%. Six variants were found with variant 3 being the most common (71%).

Conclusion:

Yemeni MSMs are mainly two-rooted. The prevalence of three- and one-rooted MSMs was relatively low. Various canals configurations were found in MSMs among this sample of Yemeni population. The clinicians should consider C-shaped roots and canals when treating Yemeni MSMs and should be aware of their morphological variations to ensure successful root canal treatment. Although bilateral similarity of many anatomical features of MSMs was found, individual evaluation of each MSM is necessary while performing endodontic treatment on both sides.

Management of an over-extruded fragment in a C-shaped root canal configuration: A case report and literature review

Separation of root canal instruments is a common incident during root canal treatments' procedures. The complex configuration of root canal systems is one of the most influencing factors, not only during the occurrence of instrument separation but also during the management of such unpleasant incidents. There are few reports on the management of fractured instruments located in the apical third of the root canals apical, especially those extruded beyond the apex. A 37-year-old woman was referred to an endodontic specialist to complete a root canal treatment after the separation of an endodontic file in the middle-third of the C-shaped root canal configuration (Vertucci type II) of the mandibular second molar. A failed attempt at managing the fragment by the dentist resulted in the backward placement of the fragment, which was more apically, and partial extrusion beyond the root apex. The fractured instrument was successfully and safely retrieved using different procedures and techniques including bypassing the fragment, loosening the fragment using ultrasonics and then removing it by the crab-claw shaped tweezers (Zumax broken instruments removal kit). This case report demonstrates the importance of high magnification provided by the dental operating microscopes and sound clinical skills and judgment, especially in assessing the difficulty of cases that is necessary for various treatment approaches. In addition, the availability of different armamentaria to manage separated instruments is essential. Finally, this case report proposes and advocates the idea of removing fractured instruments extruding beyond the apex without surgery.

Taurodontism and C-shaped anatomy: is there an association?

OBJECTIVES

To evaluate the relation between taurodontism and C-shaped configuration, as well as the prevalence and classification according to sex, left/right position, and arc length in the mandibular premolar and molar teeth using cone beam computed tomography (CBCT).

METHODS

The presence of taurodontism and C-shaped configuration were evaluated using CBCT scans and classified by two independent radiologists. The sex, location in the jaw (left-right), and mandibular arc length measurements were recorded. The Chi-square test was used to determine the presence of taurodontism and C-shape configuration according to sex, left/right location, and independent-sample t tests were used to assess the relation between the arc length.

RESULTS

The prevalence of taurodontism was significantly higher in the female population, whereas the C-shaped configuration was more frequent in males (p < 0.05). In both sexes, the most common type was hypotaurodont (7.5%). In the molars, the prevalence was significantly higher in second molars, and the most common C-shaped configuration type was C3 (39.3%). The prevalence was significantly higher in the first premolar, with C2 (22.4%) being the most frequent type in the premolars (p < 0.05). The arc length and location in the jaw were not significantly affected (p > 0.05).

CONCLUSIONS

A high correlation was revealed between taurodontism and complicated C-shape canal configurations. Practitioners should be very careful about the presence of C-shape morphology in taurodontism treatment, and various types of C-shaped morphology ranging from coronal to the apical direction.

C-shaped canals in mandibular molars of a Brazilian subpopulation: prevalence and root canal configuration using cone-beam computed tomography

OBJECTIVES

To assess C-shaped root canal configuration by identifying its prevalence and each configuration type proportion, according to tooth (mandibular first or second molar) and demographic characteristics in a Brazilian population, using cone-beam computed tomography (CBCT). Moreover, it was verified if there is a relationship between root canal configuration observed in two-dimensional reconstructions of CBCT and presence of C-shape.

METHODS

Mandibular jaw CBCT scans (184 males and 220 females, aged 15 to 80 years), which presented 1464 mandibular molars (710 first molars and 754 second molars), were assessed. Teeth were evaluated for the presence and type of C-shaped root canals by observing the roots at five levels in CBCT axial reconstructions. Root canal configuration was assessed in panoramic reconstructions. Data were statistically analyzed at a significance level of 5%.

RESULTS

Of the 1464 mandibular molars, 125 (8.5%) were classified as C-shaped. This variation was more prevalent in females (n = 107, 85.6%) and in second molars (n = 108, 86.4%). C1 (uninterrupted C-shaped canal) was the most prevalent type of C-shaped configuration (41.76%), while C5 (no canal lumen) was the least prevalent type (0.96%). Single root with single canal in panoramic reconstructions was the most predominant configuration for C-shaped teeth (n = 54, 43.2%). Fused roots presented 17.2 higher odds of being associated with C-shaped root canals than non-fused roots.

CONCLUSIONS

C-shaped root canals were more prevalent in mandibular second molars and in females. Additionally, clinicians should bear in mind the greater possibility of C-shaped configuration in mandibular molars with fused roots.

CLINICAL RELEVANCE

Mandibular molars with C-shaped canals present a clinical challenge. A higher C-shaped proportion was noted in radiographic fused root types, which had 17.2 higher odds of presenting such anatomy when compared to radiographic non-fused roots. Root radiographic features may help in diagnosis of complex C-shaped morphologies.

Root and Root Canal Morphology Differences Between Genders: A Comprehensive in-vivo CBCT Study in a Saudi Population

OBJECTIVES

To comprehensively explore the differences of all maxillary and mandibular permanent teeth in relation to number of roots, number of root canals, and root canal configuration between both genders in a Saudi Arabian population.

METHODS

This retrospective radiographic study comprised 208 subjects (48% males and 52% females) with a mean age 28.74±9.56 years. The CBCT images of the recruited subjects were evaluated for all permanent teeth. A careful examination was obtained by optimal visualization using all the software features. The data were analyzed using SPSS software program. Cohen's Kappa test was used for reliability and the Chi-squared test of association was used for the differences between both genders in relation to the study variables. A P-value < 0.05 was considered significant.

RESULTS

A total of 5254 maxillary and mandibular permanent teeth were evaluated. In relation to number of roots, there were no significant differences between both genders for all maxillary and mandibular teeth together (P= 0.064) as well as for maxillary and mandibular teeth separately (P= 0.315 and P= 0.100, respectively). A significant difference was found between males and females in relation to the number of canals of maxillary teeth (P= 0.014). For mandibular teeth, the significant level of difference was at the cut-off point (P= 0.050). For all maxillary and mandibular teeth together, the distribution among both genders was not significant (P= 0.082). The difference between both genders with regard to canal configuration of maxillary roots was highly statistically significant (P< 0.001). For mandibular teeth, the difference between males and females in relation canal configuration of anterior and premolar teeth was significant (P= 0.016) while, the difference was not significant when related to mesial roots of 1st and 2nd molars (P= 0.205). However, the difference was highly significant when related to distal roots of 1st and 2nd molars (P< 0.001).

CONCLUSION

No significant differences between both genders in relation to number of roots were found. Regarding the number of canals, significant differences were found only in three groups out of 14 groups of teeth with females who had a smaller number of canals than males. For canal configuration, two groups of maxillary teeth and three groups of mandibular teeth showed statistically significant differences between both genders.

Evaluation of Roots and Canal Systems of Mandibular First Molars in a Vietnamese Subpopulation Using Cone-Beam Computed Tomography

Objectives:

The aim of this study is to determine the prevalence of the first lower molars that have two roots or three roots and the number of the root canals of the mandibular first molars in the Vietnamese subpopulation using cone-beam computed tomography (CBCT).

Materials and Methods:

The study was conducted on 166 patients who had CBCT as indicated by dentists in Nguyen Trai Dental CT Center, Ho Chi Minh City using the Picasso Trio (Ewoo Vatech, Korea). The number of root canals of the first lower molars was examined by moving cross-sectional slices from the pulpal floor to the apex. The orifices, middle thirds, and apical thirds of the canals of the first lower molar were observed, and the root canals of each root of the mandibular first molars were observed in three planes.

Results:

The prevalence of two, three, and four root canals of the mandibular first molars was 4.5%, 66.8%, and 28.9%, respectively. For the distal roots of these molars, a classification of Vertucci type I was the most common at a rate of 80.8%–97.6%. Whenever these teeth had three roots, a Vertucci type I was the classification of 100% of distolingual roots.

Conclusion:

Majority of the mandibular first molars has two roots and three canals. CBCT is appropriate equipment useful in investigating the complex root canal morphology of human teeth.

Anatomical variations and bilateral symmetry of roots and root canal system of mandibular first permanent molars in Saudi Arabian population utilizing cone- beam computed tomography

Aim

The aim of the study was to evaluate the anatomical variations of the roots and root canal system, and to determine the symmetry between right and left sides of mandibular first permanent molars in Saudi Arabian population using images derived from cone beam computed tomography (CBCT) scans.

Methods

The CBCT scans (with the following parameters: FOV 170 × 120 mm, 90 Kv, 5–8 mA, 17.5 s exposure time and 0.25 mm voxel size) were retrieved from the database and axial, coronal and sagittal sections of mandibular first molars were examined. The number of roots, canals and type of canal configuration based on Vertucci’s classification were recorded. Bilateral symmetry between right and left side of the same individuals and differences between genders were investigated.

Results

Out of 174 mandibular first molars, 97.1% were two rooted and 2.9% were three rooted (distolingual root). In regards to the number of canals, 73% had three, 25.3% had four and 1.7% had two root canals. In teeth with four root canals, 90.9% of the extra canal was in the distal root, while 9.1% in the extra distolingual root. The most common canal configuration in mesial and distal root were type IV (64.9%) and type I (77%), respectively. Symmetrical analysis revealed 100% symmetry in number of roots and 56.4% in number of canals between right and left teeth in the same individual.

Conclusions

Within the limitation of this study, wide range of canals configurations were noted in mandibular first molars among the Saudi Arabian population. The prevalence of three rooted mandibular first molars was relatively low. Three canals were most commonly seen in mandibular first molars. Bilateral symmetry was varied in number of canals and canals configurations, which could be of clinical significance while performing root canal treatment on both side mandibular first permanent molars.

Evaluation of root canal morphology of mandibular premolars in a Saudi population using cone beam computed tomography: A retrospective study

Objective

To investigate the root canal morphology of mandibular first and second premolars using Cone-Beam Computed Tomography (CBCT) in a Saudi population.

Methods

CBCT images of 707 patients, number of roots and canal configuration were identified and categorized according to Vertucci classification. Bilateral symmetry and association between gender and number of roots, as well as gender and root canal configuration were investigated.

Results

Majority of the patients had one root and type I root canal configuration in mandibular first (96.4%) and second premolar (95.6%). All types of canal configurations were observed except Type VII for the mandibular first premolar, and Types VI and VII for the mandibular second premolar. High degree of bilateral symmetry was seen in both mandibular first and second premolars in terms of the number of roots and canal configuration; 93.8% and 97.8%, respectively. There was an association between gender and number of roots (P = 0.04) and gender and root canal configuration in mandibular first premolar (P = 0.030).

Conclusions

Single-root with type I canal configuration was the most prevalent of mandibular premolars in the Saudi population. However, incidence of more than one root with different canal configurations was detected.