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Srivastava S, Aldakhail NS, Javed MQ. Morphometric relationships in mesio-buccal roots of maxillary first molars in Saudi subpopulation: A CBCT study. AUST ENDOD J 2023; 49:614-622. [PMID: 37665125 DOI: 10.1111/aej.12793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/05/2023]
Abstract
This CBCT-based study analysed morphometric relationships in Mesio-Buccal (MB) roots of maxillary first molars (MFM). 133 MFM with two MB canals were assessed and classified using Vertucci's classification. MB roots' length and MB1-MB2 canals inter-orifice distances (IOD) were noted. The data were analysed using SPSS software. The most frequently present canal was type IV (59.4%) followed by type II (40.6%). Mean MB roots' length for canals exhibiting type IV was 9.26 ± 0.21 mm and of those exhibiting type II was 12.8 ± 0.42 mm. Statistically significant relationship was found between MB root length and canal type. Mean IOD for type II and type IV canals was 2.4 ± 0.47 and 3.8 ± 0.21 mm, respectively. Statistically significant relationship was found between IOD and canal type. Length of MB root and IOD had a significant association with canal type present in MFM. This knowledge can enhance clinicians' understanding of canal morphology which can increase predictability and success rate of endodontic treatment.
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Affiliation(s)
- Swati Srivastava
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
| | | | - Muhammad Qasim Javed
- Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraidah, Saudi Arabia
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Patel F, Ujariya U, Bharatiya R, Kothari A. Four distal root canals in a two-rooted permanent mandibular first molar: Report of a rare case, its incidence, and literature review. ENDODONTOLOGY 2022. [DOI: 10.4103/endo.endo_191_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Zhang ZH, Yao HL, Zhang Y, Wang X. Endodontic management of the maxillary first molar with special root canals: A case report and review of the literature. World J Clin Cases 2020; 8:2590-2596. [PMID: 32607336 PMCID: PMC7322432 DOI: 10.12998/wjcc.v8.i12.2590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/02/2020] [Accepted: 05/26/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND As the complex anatomy of maxillary first molars is one of the major challenges in endodontic therapy, knowledge of the complicated root canal anatomy and configuration is crucial to ensure the success of endodontic treatment and prognosis. This article presents an endodontically managed left maxillary first molar with an unusual palatal root morphology. The available literature on the anatomic variation of maxillary first molars is also reviewed.
CASE SUMMARY A 36-year-old man with no medical history presented to the Stomatology Department of Peking University Third Hospital complaining of a toothache during mastication in the maxillary left posterior region for approximately 3 mo. He had a spontaneous and intermittent toothache that had worsened, particularly at night. The diagnosis based on clinical examination, X-ray imaging, and cone beam computed tomography (CBCT) was symptomatic irreversible pulpitis. Nonsurgical endodontic therapy was performed for the left maxillary first molar. Five root canals revealed by CBCT included a special palatal root canal (1-2-1-shaped), two mesiobuccal root canals, and one distobuccal root canal. Evaluation of the CBCT images confirmed the root canal morphology and the clinician performed more effective cleaning, obturation, and therapy. Finally, the tooth was restored using composite resin, and the patient was satisfied with the result.
CONCLUSION CBCT and a complete review of the literature may be beneficial for investigating the root canal system to achieve a biological and functional therapeutic effect.
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Affiliation(s)
- Zhi-Hui Zhang
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
| | - Hai-Lin Yao
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
| | - Yan Zhang
- Department of Stomatology, Peking University Third Hospital Yanqing Hospital, Beijing 102100, China
| | - Xiao Wang
- Stomatology Department, Peking University Third Hospital, Beijing 100191, China
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Al-Alawi H, Al-Nazhan S, Al-Maflehi N, Aldosimani MA, Zahid MN, Shihabi GN. The prevalence of radix molaris in the mandibular first molars of a Saudi subpopulation based on cone-beam computed tomography. Restor Dent Endod 2020; 45:e1. [PMID: 32110531 PMCID: PMC7030963 DOI: 10.5395/rde.2020.45.e1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 09/25/2019] [Accepted: 10/01/2019] [Indexed: 11/11/2022] Open
Abstract
Objectives The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT). Materials and Methods A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2). Results Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed. Conclusions The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.
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Affiliation(s)
- Hassan Al-Alawi
- Dental Department, Ministry of Health Endodontist, Huraymala General Hospital, Riyadh, Saudi Arabia
| | - Saad Al-Nazhan
- Department of Restorative Dentistry-Endodontics, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Nassr Al-Maflehi
- Department of Preventive Dental Sciences-Biostatistics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mazen A Aldosimani
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Nabil Zahid
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin AbdulAziz University, Al Kharj, Saudi Arabia
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Root and root canal diversity in human permanent maxillary first premolars and upper/lower first molars from a 14th-17th and 18th-19th century Radom population. Arch Oral Biol 2019; 110:104603. [PMID: 31835191 DOI: 10.1016/j.archoralbio.2019.104603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 10/14/2019] [Accepted: 11/04/2019] [Indexed: 01/29/2023]
Abstract
OBJECTIVE The aim of this study was to assess whether analyzed groups from two historical periods: Late Medieval (LMP), and Modern (MP) from Radom varied in the number of tooth roots and root canal system morphology. METHODS Root morphology of 229 permanent human teeth were analyzed using Cone Beam Computed Tomography. Additionally, the mitochondrial DNA (mtDNA) of 29 individuals from the LMP and 31 from the MP was analyzed. RESULTS In LMP, the maxillary first premolars were dominated by one root, while in MP second and third roots also appeared. Maxillary first molars in LMP presented three roots, while two-rooted forms occurred in MP. All mandibular first molars from the LMP and almost all (98%) from MP presented two roots. The greatest diversity in terms of root canal number occurred in one-rooted maxillary first premolars, the mesiobuccal root of the maxillary first molars, and the mesial and distal roots of the mandibular first molars in both groups. A few haplogroups from outside Europe (C, N, and R) were recorded in the MP Radom population. Moreover, this population had substantially higher haplogroup diversity compared with the LMP population. CONCLUSION Odontological research indicates an increase in the diversity in the number of roots and the shape of root canals in MP. This information corresponds to genetic research, which also indicates an increase in the diversity of haplogroups during the MP.
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A Cone-Beam Computed Tomography Scanning of the Root Canal System of Permanent Teeth among the Moscow Population. Int J Dent 2018; 2018:2615746. [PMID: 30356403 PMCID: PMC6176338 DOI: 10.1155/2018/2615746] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/29/2018] [Indexed: 12/15/2022] Open
Abstract
Background Successful endodontic treatment requires a significant knowledge of root canal anatomy. The aim of this study was to evaluate the root and root canal number of permanent teeth among the Moscow population using cone-beam computed tomography (CBCT) scanning. Materials and methods 300 CBCT images of subjects were analyzed to study the anatomy of roots and root canal system of each tooth. The collected data were analyzed using IBM SPSS statistics software 22.0 version. Results The maxillary incisors and canines had one root with one canal in 100%. Maxillary premolars had one root with one or two canals and two roots with two canals, while mandibular premolars were single-rooted with one or two canals. Maxillary first and second molar had three separated roots, and the prevalence of four canals was more often in first molars. Mandibular molars had two roots with different number of canals. Conclusion The root canal system varies greatly among populations and even in different individuals within the same population; thus, using CBCT scanning is an effective technique in investigating the root canal system.
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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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Tomaszewska IM, Jarzębska A, Skinningsrud B, Pękala PA, Wroński S, Iwanaga J. An original micro-CT study and meta-analysis of the internal and external anatomy of maxillary molars-implications for endodontic treatment. Clin Anat 2018; 31:838-853. [PMID: 29732629 DOI: 10.1002/ca.23201] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 03/16/2018] [Accepted: 04/30/2018] [Indexed: 12/19/2022]
Abstract
The aim of this work was to conduct a radiological micro-CT study and meta-analysis to determine the morphological features of the root canal anatomy of the maxillary molars. The radiological study included micro-CT scans of 110 maxillary first molars and 98 maxillary second molars. To identify articles eligible for inclusion in our meta-analysis, PubMed, Embase, and Web of Science were search comprehensively. The following data were extracted: study type (cadaveric, intraoperative or imaging), Vertucci types of canal configuration, presence/number of canals, roots, apical foramina, apical deltas, and inter-canal communications. The mesiobuccal root was the most variable with respect to canal configuration, type I being the most common configuration followed by type II and type IV. Type I was the most common canal configuration in the distobuccal and palatal root. Regarding the number of canals in the maxillary first and second molars, one canal was most prevalent in all roots of the three molars, except for the mesiobuccal root of maxillary first molar, in which two canals were most prevalent. The most prevalent number of roots in all maxillary molars was three. Knowledge of endodontic anatomy determines the parameters of root canal treatment and significantly affects the probability of success. It is therefore especially important to know the morphology of the root canal system in order to perform endodontic treatment correctly. Clin. Anat. 31:838-853, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Iwona M Tomaszewska
- 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
| | - Bendik Skinningsrud
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.,International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - Przemysław A Pękala
- Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.,International Evidence-Based Anatomy Working Group, Krakow, Poland
| | - Sebastian Wroński
- Micro- and Nanotomography Laboratory, Faculty of Physics, AGH University of Science and Technology, Krakow, Poland
| | - Joe Iwanaga
- Seattle Science Foundation, Seattle, Washington.,Division of Gross and Clinical Anatomy, Department of Anatomy, Kurume University School of Medicine, Kurume, Fukuoka, Japan.,Kurume University School of Medicine, Dental and Oral Medical Center, Kurume, Fukuoka, Japan
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Razumova S, Brago A, Khaskhanova L, Barakat H, Howijieh A. Evaluation of Anatomy and Root Canal Morphology of the Maxillary First Molar Using the Cone-Beam Computed Tomography among Residents of the Moscow Region. Contemp Clin Dent 2018; 9:S133-S136. [PMID: 29962778 PMCID: PMC6006881 DOI: 10.4103/ccd.ccd_127_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The success of endodontic treatment depends on the knowledge of root canal system. The root canals have complex morphology and wide individual variations. The aim of this study was to evaluate the root canal morphology of the maxillary first molars among residents of the Moscow region using cone-beam computed tomography (CBCT) scanning. MATERIALS AND METHODS Three hundred CBCT images of patients aged 20-70 years old were analyzed to study the root canal system (the number of canals and the configuration according to Vertucci's classification) of the maxillary first molars. The prevalence of a second mesiobuccal (MB2) in the mesiobuccal root (MB) was recorded in each age group. RESULTS three separated roots of the maxillary first molar were observed in 100% of cases. MB2 canals were found in 59.8% of cases. A second distobuccal canal was observed in 0.5% of cases. The canal morphology in the MB root was 40.2% in Type I, 22.4% in Type II, and 37.3% in Type IV. CONCLUSION The prevalence of MB2 canals was 59.8%, and the most common canal morphology was Vertucci's Type I. Using CBCT scanning is a useful technique to evaluate and analyze the root canal system.
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Affiliation(s)
- Svetlana Razumova
- Department of Propaedeutics of Dental Diseases, Medical Institute, Peoples’ Friendship University of Russia, RUDN University, Moscow, Russia
| | - Anzhela Brago
- Department of Propaedeutics of Dental Diseases, Medical Institute, RUDN University, Moscow, Russia
| | - Lamara Khaskhanova
- Department of Propaedeutics of Dental Diseases, Medical Institute, Peoples’ Friendship University of Russia, RUDN University, Moscow, Russia
| | - Haydar Barakat
- Department of Propaedeutics of Dental Diseases, Medical Institute, Peoples’ Friendship University of Russia, RUDN University, Moscow, Russia
| | - Ammar Howijieh
- Department of Propaedeutics of Dental Diseases, Medical Institute, Peoples’ Friendship University of Russia, RUDN University, Moscow, Russia
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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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Jain P, Balasubramanian S, Sundaramurthy J, Natanasabapathy V. A Cone Beam Computed Tomography of the Root Canal Morphology of Maxillary Anterior Teeth in an Institutional-Based Study in Chennai Urban Population: An In vitro Study. J Int Soc Prev Community Dent 2017; 7:S68-S74. [PMID: 29184831 PMCID: PMC5682707 DOI: 10.4103/jispcd.jispcd_206_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/24/2017] [Indexed: 11/24/2022] Open
Abstract
Aim: This study aims to investigate the root canal anatomy of human extracted permanent maxillary anterior teeth in patients reporting to our dental institution in Chennai using cone beam computed tomography (CBCT). Materials and Methods: A total of 285 maxillary anterior teeth comprising of 100 central incisors, 85 lateral incisors, and 100 canines extracted from various patients reporting to our institution were studied. The number of roots and number of canals were assessed; following which, the root canal anatomy of each tooth was evaluated for the canal pattern using CBCT. The collected data were analyzed using IBM. SPSS statistics software 23.0 version. Results: All the teeth examined were observed to be single rooted. All maxillary central incisors displayed Type I (100%) pattern whereas maxillary laterals and canines displayed canal variations. In maxillary laterals, Type I pattern (98%) was most prevalent followed by Type II (2%) configuration. Maxillary canines revealed a predominant Type I (96%) canal pattern followed by Type II (3%) and Type III (1%). Conclusion: A varied root canal anatomy was observed in maxillary anterior teeth among Chennai urban population in this institutional-based study. The most frequent canal pattern reported in the maxillary anterior dentition was Type I. Type II was observed in both maxillary lateral incisors and maxillary canines whereas Type III canal configuration was reported only in maxillary canines.
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Affiliation(s)
- Preetham Jain
- Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, MAHER University, Chennai, Tamil Nadu, India
| | | | - Jothilatha Sundaramurthy
- Department of Conservative Dentistry and Endodontics, Tamil Nadu Government Dental College and Hospital, Tamil Nadu Dr. MGR Medical University, Chennai, Tamil Nadu, India
| | - Velmurugan Natanasabapathy
- Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, MAHER University, Chennai, Tamil Nadu, India
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Variations of Palatal Canal Morphology in Maxillary Molars: A Case Series and Literature Review. J Endod 2017; 43:1888-1896. [DOI: 10.1016/j.joen.2017.04.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 03/25/2017] [Accepted: 04/02/2017] [Indexed: 01/01/2023]
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Shetty H, Sontakke S, Karjodkar F, Gupta P, Mandwe A, Banga KS. A Cone Beam Computed Tomography (CBCT) evaluation of MB2 canals in endodontically treated permanent maxillary molars. A retrospective study in Indian population. J Clin Exp Dent 2017; 9:e51-e55. [PMID: 28149463 PMCID: PMC5268108 DOI: 10.4317/jced.52716] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 08/22/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Current technological advances have allowed application of different study designs and techniques for investigation of dental anatomy. Some clinical studies have provided evidence that Cone Beam computed tomography (CBCT) scanning is an important resource in assessment of root canal systems notably to identify MB2 canals in maxillary molars as CBCT scans allow in vivo dental investigation in axial, sagittal and coronal planes simultaneously. The current study was undertaken to detect and evaluate filled/unfilled MB2 canals in endodontically treated, asymptomatic maxillary molars utilizing cone beam computed tomography (CBCT). MATERIAL AND METHODS A retrospective study of 100 CBCTs of patients were underwent scanning for various treatment modalities, with asymptomatic endodontically treated permanent first and second maxillary molars were selected. History of root canal treatment varied from minimum of 1 year to a maximum of 10 years. Axial and paraxial images obtained were used to assess the presence of MB2 canal. Paraxial images were used to assess the periapical status. RESULTS Of the 100 scans, 66 were of permanent maxillary first molar and 34 were of permanent maxillary second molar. The incidence of MB2 canal was 86.36% in maxillary first molars and 29.4% in maxillary second molars. 77.19 % of maxillary first molars and 90% of maxillary second molars had an unfilled MB2 canal. 72.7% of maxillary first molars and 88.8% of maxillary second molars showed significant periapical radiolucencies in unfilled MB2 canals. CONCLUSIONS MB2 canals were present in majority of cases and most of the unfilled MB2 canals showed evidence of periapical radiolucencies. Key words:MB2 Canals, Cone Beam computed Tomography (CBCT), Filled /Unfilled canals, Endodontically treated teeth.
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Affiliation(s)
- Heeresh Shetty
- MDS, Assistant Professor, Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, India
| | - Subodh Sontakke
- MDS, Associate Professor, Department of Dentistry Grant Medical College and Sir JJ Group of Hospitals, Mumbai, India
| | - Freny Karjodkar
- MDS, Professor and Head, Department of Oral Medicine and Radiology, Nair Hospital Dental College, Mumbai, India
| | - Pankaj Gupta
- MDS, Assistant Professor, Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, India
| | - Ashish Mandwe
- MDS, Associate Professor, Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, India
| | - K S Banga
- MDS, Professor and Head, Department of Conservative Dentistry and Endodontics, Nair Hospital Dental College, Mumbai, India
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Hosseinpour S, Kharazifard MJ, Khayat A, Naseri M. Root Canal Morphology of Permanent Mandibular Premolars in Iranian Population: A Systematic Review. IRANIAN ENDODONTIC JOURNAL 2016; 11:150-6. [PMID: 27471522 PMCID: PMC4947835 DOI: 10.7508/iej.2016.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/01/2016] [Accepted: 01/15/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION It is essential for clinicians to have knowledge about root canal configuration, although its morphology varies largely in different ethnicities and even in different individuals within the same ethnic group. The current study reviewed the root canal configuration of root canals in mandibular first and second premolars among Iranian population based on independent epidemiological studies. METHODS AND MATERIALS A comprehensive search was conducted on retrieved articles related to root canal configuration and prevalence of each types of root canal in mandibular premolars based on Vertucci's classification. An electronic search was conducted in Medline, Scopus and Google Scholar from January 1984 to September 2015. RESULTS In eleven studies conducted in eight provinces, 1644 mandibular first premolars and 1268 second premolars were investigated. Within mandibular first premolars, 70.9% were Vertucci's type I, followed by 10.4% type III, 7.18% type IV, 5.23% type II and 5.16% type V. In addition, among mandibular second premolars, 82.86% were type I, 6.25 type III, 5.32% type II, 4.27% type IV, and 0.69% type V. CONCLUSION These results highlight the necessity of searching for additional possible root canals by clinicians. Moreover, these results indicated the ethnical characteristics of Iranian population regarding the morphology of mandibular premolars compared to other populations.
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Affiliation(s)
- Sepanta Hosseinpour
- Students' Research Office, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran;
| | | | - Akbar Khayat
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Canada;
| | - Mandana Naseri
- Department of Endodontics, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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15
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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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Briseño-Marroquín B, Paqué F, Maier K, Willershausen B, Wolf TG. Root Canal Morphology and Configuration of 179 Maxillary First Molars by Means of Micro-computed Tomography: An Ex Vivo Study. J Endod 2015; 41:2008-13. [PMID: 26518215 DOI: 10.1016/j.joen.2015.09.007] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/02/2015] [Accepted: 09/12/2015] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The objective of this study was to propose a root canal configuration description method and to investigate the root canal system morphology of the maxillary first molar by means of micro-computed tomographic imaging. METHODS The root canal configuration, foramina, and accessory canal frequency of 179 maxillary first molars were investigated by means of micro-computed tomographic imaging and 3-dimensional software imaging. The root canal configuration and main foramina number are described from coronal to apical with a 4-digit system. RESULTS The most frequent root canal configurations were 1-1-1/1 (45.8%), 2-2-2/2 (25.1%) and 2-2-1/1 (10.1%) in mesiobuccal roots and 1-1-1/1 in distobuccal (97.2%) and palatal (98.9%) roots. The first mesiobuccal (MB1) root canal had 1 accessory canal in 26.3% of the teeth, the distobuccal root canal had 12.3%, and the palatal root canal had 9.5%; in the second mesiobuccal root canal, there was rarely 1 accessory canal. There was 1 accessory canal in 26.3%, 12.3%, and 9.5% in the MB1, distobuccal, and palatal root canals, respectively. The MB1, distobuccal, and palatal root canals had 1 main foramen. The MB2 had 1 main foramen in 39.0% of the teeth and no main foramen in 61.0%. CONCLUSIONS The root canal configuration of maxillary first molars is quite diversified. Contrary to our expectations in this research, the mesiobuccal root has predominantly 1 root canal entrance and only 1 main foramen. Anatomic variations including connecting and accessory canals occur in any third of root.
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Affiliation(s)
| | - Frank Paqué
- Division of Preventive Dentistry, Periodontology, and Cariology, University of Zürich Center of Dental Medicine, Zürich, Switzerland
| | - Karolin Maier
- Department of Operative Dentistry, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Brita Willershausen
- Department of Operative Dentistry, Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Thomas Gerhard Wolf
- Department of Operative Dentistry, Johannes Gutenberg University Medical Center, Mainz, Germany.
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Variations in the Root Form and Root Canal Morphology of Permanent Mandibular First Molars in a Sri Lankan Population. ANATOMY RESEARCH INTERNATIONAL 2015; 2015:803671. [PMID: 26351583 PMCID: PMC4550767 DOI: 10.1155/2015/803671] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 08/02/2015] [Indexed: 11/18/2022]
Abstract
The present study was conducted to determine the number of roots and morphology of the root canal system of permanent mandibular first molars (M1) in a Sri Lankan population. Sample of 529 M1 teeth was used. The number of roots was examined and the lengths of the mesial and distal roots were measured to the nearest 0.01 mm. Vacuum injection protocol was used to inject China ink into the root canal system, making it transparent. Root canal morphology was recorded using Vertucci's classification. Presence of furcation canals, position of lateral canals, intercanal communications, level of bifurcation, and convergence of the root canal system were recorded. M1 showed three roots in 4.1% of the sample. Commonest root canal morphology of the mesial root was type IV and the distal root was type I. The level of bifurcation of the root canals was commonly observed in the cervical one-third of the root while convergence was observed in the apical one-third in both roots. Prevalence of three rooted mandibular first molars is less than 5%. Mesial root showed the most variable canal morphology. Prevalence of furcation canals was 1.5% while that of middle mesial canals was 0.2%.
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Abstract
OBJECTIVE The objective was to study the root canal morphology of South Asian Indian Maxillary molars using a tooth clearing technique. MATERIALS AND METHODS Hundred teeth each comprising of first, second, and third molars collected from different dental schools and clinics in India were subjected to standard dye penetration, decalcification and clearing procedure before being studied. RESULTS The first molar mesiobuccal roots exhibited 69% Type I, 24% Type II, 4% Type IV, 2% Type V, and 1% exhibited a Vertuccis Type VIII canal anatomy. In the group with three separate roots the second molar mesiobuccal roots in exhibited 80.6% Type I, 15.3% Type II, 2.7% Type IV, and 1.4% Type V canal anatomy while the third molars mesiobuccal roots exhibited 57.4% Type I, 32% Type II, 2.1% Type III, 8.5% Type IV, 1% had a Type V canal anatomy in the similar group. CONCLUSION A varied root canal anatomy was seen in the mesiobuccal root canal of the maxillary molars.
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Affiliation(s)
- Shishir Singh
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St. George Hospital compound, D Mello Road, Near GPO, Fort. Mumbai, Maharashtra, India
| | - Mansing Pawar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St. George Hospital compound, D Mello Road, Near GPO, Fort. Mumbai, Maharashtra, India
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Filpo-Perez C, Bramante CM, Villas-Boas MH, Húngaro Duarte MA, Versiani MA, Ordinola-Zapata R. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar. J Endod 2014; 41:231-6. [PMID: 25447505 DOI: 10.1016/j.joen.2014.09.024] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 09/15/2014] [Accepted: 09/27/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the morphologic aspects of the root canal anatomy of the distal root of a mandibular first molar using micro-computed tomographic analysis. METHODS One-hundred distal roots of mandibular first molars were scanned using a micro-computed tomographic device at an isotropic resolution of 19.6 μm. The percentage frequency distribution of the morphologic configuration of the root canal was performed according to the Vertucci classification system. Two-dimensional parameters (area, perimeter, roundness, aspect ratio, and major and minor diameters) and the cross-sectional shape of the root canal were analyzed in the apical third at every 1-mm interval from the main apical foramen in roots presenting Vertucci types I and II configurations (n = 79). Data were statistically compared using the Kruskal-Wallis and Dunn tests with a significance level set at 5%. RESULTS Seventy-six percent of the distal roots had a single root canal. Two, three, and four canals were found in 13%, 8%, and 3% of the sample, respectively. In 13 specimens, the configuration of the root canal did not fit into Vertucci's classification. Overall, 2-dimensional parameter values significantly increased at the 3-mm level (P < .05). The prevalence of oval canals was higher at the 1-mm level and decreased at the 5-mm level in which long oval and flattened canals were more prevalent. CONCLUSIONS The distal roots of the mandibular first molars showed a high prevalence of single root canals. The prevalence of long oval and flattened canals increased in the coronal direction. In 13% of the samples, canal configurations that were not included in Vertucci's configuration system were found.
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Affiliation(s)
- Carolina Filpo-Perez
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Clovis Monteiro Bramante
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Marcelo Haas Villas-Boas
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Marco Antonio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil
| | - Marco Aurélio Versiani
- Department of Restorative Dentistry, Dental School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Ronald Ordinola-Zapata
- Department of Dentistry, Endodontics and Dental Materials, Bauru School of Dentistry, University of São Paulo, University of São Paulo, São Paulo, Brazil.
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Abstract
Root canal treatment is a technically demanding procedure especially in the case of maxillary first molar where the anatomy is extremely variable. Failure to recognise and treat these variations may lead to unpredictable outcomes. This case report describes non-surgical endodontic treatment of a maxillary first molar with two palatal and two mesiobuccal canals. It also highlights the need for good anatomical knowledge of root canal morphology and its variations in order to achieve consistently successful results.
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Affiliation(s)
- Fahad Umer
- Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan
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Bhuyan AC, Kataki R, Phyllei P, Gill GS. Root canal configuration of permanent maxillary first molar in Khasi population of Meghalaya: An in vitro study. J Conserv Dent 2014; 17:359-63. [PMID: 25125850 PMCID: PMC4127696 DOI: 10.4103/0972-0707.136511] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 12/08/2013] [Accepted: 06/03/2014] [Indexed: 12/13/2022] Open
Abstract
AIMS AND OBJECTIVE To investigate the root canal configuration of permanent maxillary first molar in Khasi population of Meghalaya. MATERIAL AND METHODS Sixty (60) permanent maxillary first molars collected from patients of Khasi population of Meghalaya were studied using canal staining and clearing technique. Observations of the number of roots, root canal configuration, lateral canal, apical delta, and presence of the additional type of canals were made. RESULTS Based on Vertucci's classification the different types of canal identified are: Mesiobuccal root, Type I (28.3%), Type II (28.3%), Type IV (30.0%), Type V (5.0%), Type VI (6.7%), and an additional type of canal (2-1-2-1-2; 1.7%) were observed. The distobuccal root displayed Type I (95%), Type II (1.7%), Type V (3.3%). The most prevalent canal configuration in the palatal roots is Type I (98.3%), Type II (1.7%). CONCLUSION In Khasi population of Meghalaya, the most prevalent root canal configuration in the mesiobuccal root is Type IV followed by Type I and Type II. MB2 canals are present in more than 65% cases. In palatal and distobuccal roots, Type I configuration is present in most cases. Racial divergence may be responsible for such variations.
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Affiliation(s)
- Atool Chandra Bhuyan
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - Rubi Kataki
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - Pynshngain Phyllei
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
| | - Gurdeep Singh Gill
- Department of Conservative Dentistry and Endodontics, Regional Dental College, Guwahati, Assam, India
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Hasan M, Rahman M, Saad N. Mandibular first molar with six root canals: a rare entity. BMJ Case Rep 2014; 2014:bcr2014205253. [PMID: 25082869 PMCID: PMC4120025 DOI: 10.1136/bcr-2014-205253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2014] [Indexed: 11/04/2022] Open
Abstract
Recently, there has been an ongoing trend of case reports that highlight the presence of more than four root canals in mandibular first molars. This tendency warns clinicians to be more prudent when dealing with mandibular first molars requiring endodontic treatment. Moreover, radiographic examination should be taken as a clue providing tool rather than as an absolute guide to anatomy and its associated aberrances. This case reports the successful non-surgical endodontic management of a mandibular first molar with six root canal systems with three canals in the mesial root and three in the distal root. The classification of root canal systems found in this case was Sert and Bayirli type XV in both the roots. After non-surgical endodontic treatment, the tooth was restored definitively with a resin composite core followed by porcelain fused to the metal crown. This case adds to the library of previously reported cases of mandibular first molars with six root canals and further emphasises on the importance of rare morphological deviations that may occur in the mandibular first molars.
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Affiliation(s)
- Muhammad Hasan
- Dental Section, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Munawar Rahman
- Dental Section, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
| | - Najeeb Saad
- Dental Section, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
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Singh S, Pawar M. Root canal morphology of South asian Indian mandibular premolar teeth. J Endod 2014; 40:1338-41. [PMID: 25043328 DOI: 10.1016/j.joen.2014.03.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 03/07/2014] [Accepted: 03/25/2014] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this study was to study the root canal morphology of South Asian Indian mandibular premolars using a tooth clearing technique. METHODS Two hundred mandibular premolar teeth were collected from different dental schools and clinics in India. After pulp tissue removal and root canal staining with Indian ink, the specimens were decalcified with 5% nitric acid, dehydrated in ethyl alcohol, and subsequently cleared in methyl salicylate. RESULTS Of the 200 mandibular premolars, 100 were first premolars and 100 were second premolars. Of the first premolars, 94% had a single root, whereas 6% were 2 rooted. Seventy-six percent had a single canal, 22% had 2 canals, and 2% had 3 canals. Eighty-two percent had a single apical foramen, 16% had 2 foramens, and 2% teeth had 3 apical foramens. Eighty percent of teeth had type I, 6% had type II, 10% had type IV, 2% had type V, and 2% teeth had type IX root canal anatomy. Of the 100 second premolars, 92% had a single root, whereas 8% teeth were 2 rooted and fused. Fifty-eight percent of teeth had a single canal, and 42% had two canals. Eighty-eight percent had a single apical foramen, and 12% had 2 foramens. Sixty-six percent had type I, 30% had type II, and 4% had type V root canal anatomy. CONCLUSIONS A high prevalence of 2 canals was noted in the first and second premolars. Also, 20% of first premolars and 34% of second premolars had a root canal anatomy other than type I.
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Affiliation(s)
- Shishir Singh
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St George Hospital Compound, Mumbai, India.
| | - Mansing Pawar
- Department of Conservative Dentistry and Endodontics, Government Dental College and Hospital, St George Hospital Compound, Mumbai, India
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Keçeci AD, Ureyen Kaya B, Sener E. Determination of canal orifice co-ordinates and MB2 incidence of maxillary first molars in a Turkish sub-population. Acta Odontol Scand 2014; 72:354-61. [PMID: 24495011 DOI: 10.3109/00016357.2013.837959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To measure the co-ordinates of the root canal orifices and to determine the incidence of mesiobuccal-2 (MB2) in maxillary first molars in a Turkish sub-population. MATERIALS AND METHODS Standard digital photographs were taken under a stereomicroscope from the occlusal aspect of each tooth (n = 176) before and after crown removal. Canal orifices were negotiated under moderate magnification using dental loupes. The coordinates of the orifices and the distances of each from the central fossa were measured by using geographic software. Intensity maps of the orifice locations were created by using the co-ordinates of all canal orifices. A representative map was drawn using the mean values of orifice locations and access projection area. RESULTS In the right maxillary first molars, the mean values for the (X, Y) co-ordinates were (0.67, 2.68) for mesiobuccal-1 (MB1), (0.81, 0.84) for MB2, (-1.12, 1.26) for distobuccal-1 (D1), (-0.89, 0.23) for distobuccal-2 (D2) and (0, -2.50) for palatinal (P); the corresponding mean values in the left maxillary first molars were (-0.78, 2.56), (-0.98, 0.90), (0.99, 1.18), (0.69, 0.78) and (0.00, -2.53), respectively. The average MB1-MB2 distance was 1.97 mm. Distobuccalcanal orifices were localized at the distal side of the center in 98.3% of teeth. The incidence of MB2 was 46.02%. CONCLUSIONS The distobuccal canal orifice is mostly located on the distal side of the central fossa. Thus, it should be considered that the access cavity of the maxillary molars may not be always limited mesially. The incidence of MB2 in this sub-population was 46.02%, which is of great importance clinically.
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Hasan M, Umer F. Endodontic retreatment of a mandibular first molar with five root canal systems: an important clinical lesson. BMJ Case Rep 2014; 2014:bcr-2013-201402. [PMID: 24654237 DOI: 10.1136/bcr-2013-201402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The objective of root canal treatment is to perform complete debridement of the root canals and subsequent obturation to facilitate healing of periapical pathosis. However, this process becomes complicated with the presence of additional root canal systems. The purpose of the present article is to report successful non-surgical retreatment of a mandibular first molar with five canals. This case report discusses the clinical management of a previously root filled mandibular firstmolar with two missed canal systems; distolingual and an additional mesial canal known as the middle mesial canal. The post-treatment radiographs show successful obturation to length in all canals. The middle mesial canal was found to be associated with mesiolingual canal and categorised as confluent. The configuration of canals in the mesial root was type XV, based on the classification given by Sert and Bayirli. This case report highlights the importance of knowledge and its application in the management of abnormal anatomic variants which play a crucial role in the success of endodontic retreatment.
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Affiliation(s)
- Muhammad Hasan
- Operative Dentistry, Dental Section, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan
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Subbiya A, Kumar KS, Vivekanandhan P, Prakash V. Management of mandibular first molar with four canals in mesial root. J Conserv Dent 2013; 16:471-3. [PMID: 24082581 PMCID: PMC3778634 DOI: 10.4103/0972-0707.117495] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Revised: 05/14/2013] [Accepted: 07/11/2013] [Indexed: 11/04/2022] Open
Abstract
Successful root canal treatment depends on adequate cleaning, shaping, and filling of the root canal system. The presence of middle mesial (MM) root canal of mandibular molars has been reported by various authors. But incidence of four canals in mesial root of mandibular molar is very rare. The aim of this case report is to present and describe the identification and management of a mandibular first molar with four canals in the mesial root and single canal in the distal root.
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Affiliation(s)
- Arunajatesan Subbiya
- Department of Conservative and Endodontics, Sree Balaji Dental College and Hospital, Chennai, Tamil Nadu, India
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Garg AK, Tewari RK, Agrawal N. Prevalence of Three-Rooted Mandibular First Molars among Indians Using SCT. Int J Dent 2013; 2013:183869. [PMID: 23840212 PMCID: PMC3693170 DOI: 10.1155/2013/183869] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 05/29/2013] [Indexed: 11/17/2022] Open
Abstract
Undetected extra roots or root canals are a major reason for failure of endodontic treatment. Failure to recognize an extra distolingual (DL) root in mandibular first molar may lead to incomplete debridement of the root canal system and eventually treatment failure. Therefore, it is crucial that atypical anatomy is identified before and during dental treatment. Spiral computed tomography (SCT) images can show 3D images, and therefore much detail can be used when traditional methods prevent adequate endodontic treatment. The overall incidence of DL roots on the mandibular first molars was 6.40% for all patients and 5.00% for all teeth, respectively. The occurrence of DL roots on the right side and on the left side showed a statistically significant difference. The bilateral incidence of symmetrical distribution of DL roots was 56.25%. The DL root canal orifice was separated from DB canal orifice by 2.79 ± 0.34 mm, from the MB canal orifice by 4.23 ± 0.81 mm, and from the ML canal orifice by 3.29 ± 0.52 mm. The high prevalence of the DL root in permanent mandibular first molars among the Indian population by using SCT and estimations of the interorifice distance of such teeth might be useful for successful endodontic treatments.
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Affiliation(s)
- Amit Kumar Garg
- Department of Conservative Dentistry and Endodontics, Modern Dental College & Research Centre, Indore, India
| | - Rajendra Kumar Tewari
- Department of Conservative Dentistry and Endodontics, Dr. Z. A. Dental College, AMU, Aligarh, India
| | - Neha Agrawal
- Department of Public Health Dentistry, Modern Dental College & Research Centre, Indore, India
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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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Domark JD, Hatton JF, Benison RP, Hildebolt CF. An ex vivo comparison of digital radiography and cone-beam and micro computed tomography in the detection of the number of canals in the mesiobuccal roots of maxillary molars. J Endod 2013; 39:901-5. [PMID: 23791260 DOI: 10.1016/j.joen.2013.01.010] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Revised: 01/17/2013] [Accepted: 01/30/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The purpose of this study was to compare digital periapical and cone-beam computed tomography (CBCT) images to determine the number of canals in the mesiobuccal root of maxillary molars and to compare these counts with micro computed tomography (μCT), which was also used to determine canal configuration. METHODS Digital periapical (RVG 6100), CBCT (9000 3D), and μCT images (the reference standard) were obtained of 18 hemi-maxillas. With periapical and CBCT images, 2 endodontists independently counted the number of canals in each molar and repeated the counts 2 weeks later. Teeth were extracted and scanned with μCT, and 2 additional endodontists, by consensus, determined the number and configuration of canals. The Friedman test was used to test for differences. RESULTS In mesiobuccal roots, 2 canals were present in 100% of maxillary first molars (13 of 13) and 57% of second molars (8 of 14), and 69% (9 of 13) and 100% (8 of 8) of these exited as 2 or more foramina. There was no difference in canal counts for original and repeat reads by the 2 observers with periapical (P = .06) and with CBCT (P = .88) and no difference when CBCT counts were compared with μCT counts (P = .52); however, when periapical counts were compared with μCT counts, there was a significant difference (P = .04). CONCLUSIONS For cadaver maxillary molars, μCT canal counts were significantly different from digital periapical radiograph counts but not different from Carestream9000 3D CBCT counts.
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Affiliation(s)
- Jeffrey D Domark
- Department of Endodontics, Center for Advanced Dental Education, Saint Louis University, St Louis, MO 63104, USA
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30
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Deepalakshmi M, Karumaran CS, Miglani R, Indira R. Independent and confluent middle mesial root canals in mandibular first molars: a report of four cases. Case Rep Dent 2012; 2012:103125. [PMID: 22792497 PMCID: PMC3389654 DOI: 10.1155/2012/103125] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2012] [Accepted: 05/15/2012] [Indexed: 11/25/2022] Open
Abstract
Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars.
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Affiliation(s)
- Mohanavelu Deepalakshmi
- Department of Conservative Dentistry & Endodontics, Chettinad dental college, Chettinad Health City & Research Institute, Old Mahabalipuram Road, Kelambakkam 603103, Chennai, India
| | | | - Revathi Miglani
- Department of Conservative Dentistry & Endodontics, Ragas Dental College & Hospital, Uthandi 600119, Chennai, India
| | - Rajamani Indira
- Department of Conservative Dentistry & Endodontics, Ragas Dental College & Hospital, Uthandi 600119, Chennai, India
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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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32
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Bansal R, Mittal S, Kumar T, Kaur D. Radix entomolaris in mandibular first molars—an endodontic challenge. Indian J Dent 2011. [DOI: 10.1016/s0975-962x(11)60025-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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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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Karaman GT, Onay EO, Ungor M, Colak M. Evaluating the potential key factors in assessing the morphology of mesiobuccal canal in maxillary first and second molars. AUST ENDOD J 2010; 37:134-40. [PMID: 22117721 DOI: 10.1111/j.1747-4477.2010.00240.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to provide further information on the morphology of the root canals and pulp chambers of 100 maxillary first and 100 maxillary second molars, with particular reference to the anatomical relationship of the root canal patterns and the distance between mesiobuccal (MB) and mesiolingual (ML) orifices. Each transverse section was digitally imaged to measure the interorificial distance using a stereomicroscope. The angles of primary curvatures were determined in both buccolingual (clinic view, CV) and mesiodistal (proximal view, PV) directions and the canal configuration of the MB root was classified according to the Weine classification. The rhomboidal pulp chamber floor morphology predominated in each tooth type. The mean interorificial distance in both maxillary first and second molars was significantly shorter in type II compared with type III (P < 0.05). The interorificial distance was correlated with the primary curvature of MB canal in PV in maxillary first molars (P < 0.05), whereas the primary curvature of ML canal in CV was correlated with the primary curvature of ML canal in PV in maxillary second molars (P < 0.01). The evaluation of interorificial distance in both types of maxillary molars and the curvature of ML canal in CV in maxillary second molar can give valuable information to the clinician.
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Neelakantan P, Subbarao C, Subbarao CV, Ravindranath M. Root and Canal Morphology of Mandibular Second Molars in an Indian Population. J Endod 2010; 36:1319-22. [DOI: 10.1016/j.joen.2010.04.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 03/27/2010] [Accepted: 04/01/2010] [Indexed: 11/16/2022]
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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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Faramarzi F, Fakri H, Javaheri HH. Endodontic treatment of a mandibular first molar with three mesial canals and broken instrument removal. AUST ENDOD J 2010; 36:39-41. [DOI: 10.1111/j.1747-4477.2009.00162.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Evaluation of Root and Canal Systems of Mandibular First Molars in Taiwanese Individuals Using Cone-beam Computed Tomography. J Formos Med Assoc 2010; 109:303-8. [DOI: 10.1016/s0929-6646(10)60056-3] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Revised: 06/24/2009] [Accepted: 06/24/2009] [Indexed: 11/20/2022] Open
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Arora S, Tewari S. The morphology of the apical foramen in posterior teeth in a North Indian population. Int Endod J 2009; 42:930-9. [PMID: 19751292 DOI: 10.1111/j.1365-2591.2009.01597.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AIM To determine the position and shape of the apical foramina in posterior teeth derived from an Indian population. METHODOLOGY A total of 800 freshly extracted maxillary and mandibular premolar and molar teeth from a native Haryana population were collected. Apices of teeth were stained with methylene blue and then examined stereomicroscopically (40x). The following observations were made: number of apical foramina; size and shape of the minor apical foramen; accessory foramina frequency, and deviation of the minor apical foramina (frequency and distance) from the apex. RESULTS The mean maximum and minimum diameter of the minor apical foramina ranged from 0.158 to 0.323 mm. The most common minor apical foramen shape was oval (81%). Frequency of accessory foramina was between 2% and 41% for the various tooth types. The frequency of deviation of the minor apical foramina from the anatomic apex varied from 43% to 83% and the distance of deviation in all the teeth was between 0.052 and 2.921 mm. CONCLUSIONS The incidence of oval canals was higher in this Indian population compared to other populations. In 92% and 96% of teeth the difference between the maximum and the minimum diameter of all foramina was less than or equal to 0.20 and 0.25 mm, respectively. Therefore, four to five instrument sizes larger than the first binding file would have been necessary to shape the minor apical foramen of more than 95% of the teeth included in this study to make them round.
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Affiliation(s)
- S Arora
- Department of Operative Dentistry and Endodontics, Government Dental College, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, 124001 India
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41
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Chen G, Yao H, Tong C. Investigation of the root canal configuration of mandibular first molars in a Taiwan Chinese population. Int Endod J 2009; 42:1044-9. [DOI: 10.1111/j.1365-2591.2009.01619.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Holderrieth S, Gernhardt CR. Maxillary molars with morphologic variations of the palatal root canals: a report of four cases. J Endod 2009; 35:1060-5. [PMID: 19567335 DOI: 10.1016/j.joen.2009.04.029] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 04/21/2009] [Accepted: 04/25/2009] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The purpose of this article was to show the importance of the knowledge of the anatomy of root canals. Unusual root and root canal morphologies associated with both buccal roots of upper molars have been recorded in several studies in the literature. However, scientific information focusing on variations of the palatal root is rare. METHODS In this report, four cases are presented involving the root canal treatment of maxillary first and second molars with unusual morphologic configurations of the palatal root canals. RESULTS During root canal treatment, type IV and V configurations as defined by Vertucci of the palatal canals of two first and two second maxillary molars were identified. After mechanical instrumentation, the canals were obturated. Radiologic and clinical re-evaluation showed no signs of inflammation. CONCLUSIONS This report describes and discusses the possibility of different root and canal variations of the maxillary molars from a clinical point of view. Anatomic variations can occur in any tooth, and palatal roots of maxillary first and second molars are no exception. Therefore, careful examination of radiographs and internal anatomy of teeth is essential.
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Affiliation(s)
- Silke Holderrieth
- Department of Operative Dentistry and Periodontology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
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Al-Qudah AA, Awawdeh LA. Root and canal morphology of mandibular first and second molar teeth in a Jordanian population. Int Endod J 2009; 42:775-84. [DOI: 10.1111/j.1365-2591.2009.01578.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Root and canal morphology of mandibular first and second permanent molar teeth in a Ugandan population. Odontology 2009; 97:92-6. [DOI: 10.1007/s10266-009-0100-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2008] [Accepted: 01/05/2009] [Indexed: 10/20/2022]
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Weng XL, Yu SB, Zhao SL, Wang HG, Mu T, Tang RY, Zhou XD. Root Canal Morphology of Permanent Maxillary Teeth in the Han Nationality in Chinese Guanzhong Area: A New Modified Root Canal Staining Technique. J Endod 2009; 35:651-6. [DOI: 10.1016/j.joen.2009.02.010] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Revised: 02/03/2009] [Accepted: 02/17/2009] [Indexed: 10/20/2022]
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The Prevalence of Three-rooted Mandibular Permanent First Molars in a German Population. J Endod 2009; 35:202-5. [PMID: 19166773 DOI: 10.1016/j.joen.2008.11.010] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2008] [Revised: 10/27/2008] [Accepted: 11/02/2008] [Indexed: 11/22/2022]
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Pattanshetti N, Gaidhane M, Al Kandari AM. Root and canal morphology of the mesiobuccal and distal roots of permanent first molars in a Kuwait population - a clinical study. Int Endod J 2008; 41:755-62. [DOI: 10.1111/j.1365-2591.2008.01427.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Furri M. Differences in the confluence of mesial canals in mandibular molar teeth with three or four root canals. Int Endod J 2008; 41:777-80. [DOI: 10.1111/j.1365-2591.2008.01431.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shahi S, Yavari HR, Rahimi S, Torkamani R. Root canal morphology of human mandibular first permanent molars in an Iranian population. J Dent Res Dent Clin Dent Prospects 2008; 2:20-3. [PMID: 23285325 PMCID: PMC3533633 DOI: 10.5681/joddd.2008.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2007] [Accepted: 01/20/2008] [Indexed: 11/17/2022] Open
Abstract
Background and aims
The knowledge of variations in root canal morphology is critical for a successful endodontic treatment. The purpose of this study was to investigate variations in the root canal system of human mandibular first permanent molars in an Iranian population.
Materials and methods
In this study, 209 mandibular first molar teeth were decalcified, dye-injected, and cleared in order to determine the number and configuration of the root canals.
Results
The results demonstrated that 65.56% of the mandibular first molars under study had three, 31.57% had four and 2.87% had two canals.
Conclusion According to the results of this study and considering variations in the root canal systems of the mandibular first molars, it seems that great care should be taken in the root canal treatment of these teeth.
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Affiliation(s)
- Shahriar Shahi
- Associate Professor, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences
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