Root and canal morphology of Burmese maxillary molars

Maxillary first molar with two distobuccal root canals and cervical deformity: A case report

The second distobuccal canal in the maxillary first molar is often missed because of the low prevalence rate (0%-4%). The article reports this kind of variation in one case. Promising outcomes have continued up to the present (2-year follow-up).

Cone beam computed tomography analysis of the root and canal morphology of the maxillary second molars in a Hail province of the Saudi population

Background

The goal of the present research was to employ CBCT imaging to assess the root and canal anatomy of maxillary second molars in a population from the Hail province of Saudi. The effects of gender and side were taken into account.

Methods

The investigation included a sample size of 499 completely developed right and left untreated maxillary second molars obtained from 250 Saudi people. The root morphology of each tooth was evaluated. The examination also included an analysis of the canal morphology for each tooth, utilizing Vertucci's categorization. The effect of genders as well as sides was recorded. Results were analyzed using the Chi-square test.

Results

464 teeth had three roots (93.0%), whereas 20 teeth (4.0%) had two roots. One root was recorded in 7 (1.4%) of the study sample, whilst 8 (1.6%) had four roots. Although there were no significant differences between the left and right sides (p = .075), gender had a significant influence on the number of roots (p = .030). 240 M (48.1%) had three canal orifices, and 247 (49.5%) had four root canal orifices. Eight molars (1.6%) had two canal orifices, while one and five canal orifices were found in 3 (0.6%) and one (0.2%), respectively. Gender had a significant impact on the number of root canal orifices (p = .039). The observed differences in the orifices of the root canals between the left and right sides were not statistically significant (p = .059). The prevalence of MB2 in maxillary second molars was found to be 49.7%. In the mesiobuccal root, the Vertucci type I configuration had the highest canal frequency (50.3%), followed by the Vertucci types II (14.4%), IV (13.8%), V (12.0%), and III (7.6%), and VI (1.8%). The prevalence of Vertucci type I canal configurations was found to be higher in the distobuccal root (99.4%) and palatal root (98.2%) of maxillary second molars.

Conclusions

Significant variations in root canal anatomy were observed within the Saudi population. The majority of the subjects from Saudi Arabia in this study exhibited the presence of maxillary second molars with three roots. Approximately half of the sample under investigation exhibited the presence of the four canals.

Root and canal morphology of maxillary second molars in a Black South African subpopulation using cone-beam computed tomography and two classifications

This study investigated the root and canal morphology of maxillary second molars in a Black South African population using high-resolution cone-beam computed tomography. In total, 386 maxillary second molar teeth were evaluated and described according to the classifications of Vertucci (with the additions of Sert and Bayirli), as well as Ahmed et al. Root number, fusions and canal morphology were recorded. Relationships between morphology, sex and age were assessed using Fisher's exact test (p < 0.05). Maxillary second molars were predominantly three-rooted (96.1%), with root fusion observed in 14%. No relationships between sex, age and canal morphology were found. Additional canals were observed in 67.4% of mesiobuccal roots. The Ahmed et al. classification provided a better overall description of the morphology. In this population, maxillary second molar teeth exhibited a diversity of root and canal morphology. Complex variations may render endodontic management more difficult and increase the possibility of missed anatomy.

Rare root canal morphology of maxillary second molars: A report of three cases

Key Clinical Message

Endodontists should be aware that some maxillary second molars can have more than three roots. If any unusual anatomical features are detected during dental radiography or endodontic procedures, it is necessary to conduct cone-beam computed tomography (CBCT) scanning to prevent procedural mishaps.

Abstract

CBCT can provide three-dimensional reconstructed images of the root canal system. With the help of CBCT, variations in tooth root number and root canal morphology, such as extra canals, apical ramifications, apical deltas, and lateral canals, can be identified. Knowledge of the variations is very important for the success of endodontic treatment. This report suggests that endodontists must not assume that a MSM has only three tooth roots, which is the most prevalent number.

Root and canal morphology of third molar teeth

Restorative and prosthetic considerations usually necessitates endodontic treatment of third molars in order to retain them as a functional component of the dental arch. However, the anatomy of third molars has been described as unpredictable. To date, there has been little published work on root and canal morphology of third molars, with an adequate sample size. The aim of this study was to investigate root and canal morphology of third molars. Maxillary and mandibular third molars were gathered from dental surgeries within north Jordan. Following access cavity preparation, pulp tissue was removed and root canals stained. Teeth were subject to examination after rendering them clear by immersion in methyl salicylate, and the following features evaluated: (1) number of roots; (2) number and type of root canals; (3) number and position of lateral canals; and (4) presence of inter-canal communications. Out of the examined 592 maxillary third molars, 69.9% had three roots, 10.81% had one, 9.79% had two, 9.12% had four, and 0.34% had five roots. Most had three (52.36%) and four canals (28.2%) with less frequency of two (11.48%), one (5.91%) and five canals (2.03%). Of the 639 mandibular third molars, 89.76% had two roots, 7.35% had three, 2.5% had one, and 0.47% had four roots. Most had three (55.71%) and two canals (29.42%) with less frequency of four (13.61%), one (1.09%) and five canals (0.15%). The majority of maxillary third molars had 3 roots, while the majority of mandibular third molars had two. Overall, nearly half of the maxillary and mandibular third molars had three canals. New canal configurations, not previously described in the literature nor included in Vertucci's classifications, were identified in both maxillary and mandibular third molars.

Retreatment of a C-shaped maxillary second molar: case reports and literature review

The root canal systems of maxillary second molar (MSM) variations are complicated, especially the prevalence of fused roots and consequent merged and C-shaped canals, which represent a clinical challenge because canal configurations can be irregular and unpredictable. The purpose of this article was to present 2 cases with a C-shaped configuration diagnosed during root canal retreatment and perform a literature review of this MSM anatomy. Case 1 reports that two palatal root canals fused into a C-shaped configuration that finally formed an apical foramen, which was classified as Type D. Case 2 reflects the fusion of the distobuccal canal and palatal canal into a C-shaped configuration and the configuration was Type C, which was first reported in a case report. Nonsurgical retreatments were proposed and conducted. Evaluation at a 24-month recall revealed that the two patients were symptom-free, and radiographic examination revealed normal periapical tissue. This report serves to remind clinicians of the complexities of the root canal system and that possible anatomic variation should always be anticipated when formulating an effective root canal treatment plan. The use of CBCT imaging coupled with an operative dental microscope will be helpful in locating and identifying supernumerary canals when a preoperative periapical radiograph shows signs of a fused-rooted MSM.

CBCT Analysis of Maxillary First Molar in Indian Population

Aim

This study aimed to assess the variations in root canal morphology of permanent maxillary first molar with the use of cone-beam computed tomography (CBCT).

Materials and methods

One hundred extracted teeth were cleaned and arranged in U shape template mimicking natural arch in set of five teeth. These arches were scanned in CBCT and were analyzed by expert radiologist for number of roots, number of canals per root, and Vertucci classification.

Result

A maximum number of permanent maxillary first molars had three roots, and only 2% had two roots. All the palatal roots and 99% of distobuccal roots had one canal, but one of the distobuccal roots had two canals. Incidence of two canals in MB root is more frequent (60%) than incidence of one canal. The most common type of Vertucci's classification for MB root is a type I, followed by type IV, type II, type VI, type V, type VII.

How to cite this article

Sharma M, Gupta S, Bhayya DP, et al. CBCT Analysis of Maxillary First Molar in Indian Population. Int J Clin Pediatr Dent 2022;15(3):258-262.

Anatomical Evaluation of Root and Root Canal Configuration of Permanent Maxillary Dentition in the Population of the Kingdom of Saudi Arabia

AIM

This study is aimed at combining the sample sizes of all studies on permanent maxillary teeth conducted in different regions of the Kingdom of Saudi Arabia (KSA) to obtain a large sample size that represents the population of the KSA. The outcome of these combined studies is compared with international studies in terms of the number of roots, number of canals, and canal configurations on the basis of Vertucci's classification. Methodology. The studies were systematically reviewed using the Preferred Reporting Items for Systematic Review and Meta-analysis chart. Studies were included in the analysis if they were conducted in the KSA, involved permanent human maxillary teeth, and had a sample of more than 10 teeth (power). By contrast, studies were excluded if they involved deciduous teeth in the sample size, investigated nonhuman teeth, were not conducted in the KSA, and were case reports, case series, review studies, and anomalies. Relevant literature was searched from PubMed, Scopus, Web of Science, Embase, Cochrane, and Direct Science by two calibrated teams, starting in August 2020, without time limits or language restrictions.

RESULTS

The database searches and cross-referencing identified a total of 19 relevant studies. All maxillary canines (N = 1,018) had one root, whereas 98.4% had one canal and 98.3% had Vertucci type I. Moreover, 63.2% of the maxillary first premolars had two roots, and 91.4% had two canals. The most common Vertucci root canal configuration was type IV (64.6%). The maxillary second premolars mostly had one root (84.4%) and one canal (50.4%). The most common canal configuration was Vertucci type I (47.1%). The majority of maxillary first molars had three roots (98.9%), 48.7% of which had three canals, and 46.4% had four canals. The most prevalent feature of the canal morphology of mesiobuccal roots was Vertucci type II (35.3%). The investigated maxillary second molars had three roots, 88.0% of which had three canals.

CONCLUSION

This systematic review represents the Saudi population since samples were combined from different studies from different regions of the country. Variations in findings were observed in the same group of teeth from different regions and the same region, while the overall combined samples results fell within the range of other international studies.

Evaluation of mesial root canal configuration of mandibular first molars using micro-computed tomography

Purpose

The aim of this study was to evaluate the root canal morphology of mesial roots of mandibular first molars.

Materials and Methods

Forty extracted mandibular first molars were used in this study. The morphological examination of root canals was conducted in accordance with the Vertucci classification using micro-computed tomography (micro-CT). Any aberrant root canal configurations not included in the Vertucci classification were recorded, and their frequency was established using descriptive statistics. Intra-observer reliability was assessed using the Wilcoxon signed-rank test, while inter-observer reliability was assessed using the Cohen kappa test. Significance was evaluated at the P<0.05 level.

Results

The mesial roots of mandibular first molars had canal configurations of type I (15%), type II (7.5%), type III (25%), type IV (10%), type V (2.5%), type VI (7.5%), and type VII (7.5%). The images showed 10 (25%) additional configuration types that were not included in the Vertucci classification. These types were 1-3-2-3, 1-2-3-2-3, 2-3-1, 2-3, 1-2-3-1, 2-1-2-3, 3-2-1, 1-2-3-1, 2-3-2-3, and 1-2-1-2-1. The intra-observer differences were not statistically significant (P>0.05) and the kappa value for inter-observer agreement was found to be 0.957.

Conclusion

Frequent variations were detected in mesial roots of mandibular first molars. Clinicians should take into consideration the complex structure of the root canal morphology before commencing root canal treatment procedures to prevent iatrogenic complications. Micro-CT was a highly suitable method to provide accurate 3-dimensional visualizations of root canal morphology.

Root Canal Configuration of Burmese (Myanmar) Maxillary First Molar: A Micro-Computed Tomography Study

Aim

To investigate the root canal anatomy of Burmese (Myanmar) permanent maxillary first molar (BMFM) with micro-computed tomography. Methodology. One hundred and one extracted BMFMs were scanned by a SkyScan 1272 scanner (Bruker microCT, Belgium) and reconstructed with NRecon software (Bruker microCT). CTAn software (Bruker microCT) was used to create 3D models of root and internal canal anatomy, while CTVol software (Bruker microCT) was used to visualize 3D models. In each root, Vertucci's canal types, incidence and location of the lateral canal, incidence, location, and type of isthmus, and number and position of foramina were examined.

Results

In 101 specimens, 83 (82.18%) mesiobuccal roots had multiple canals. The most common canal type is type IV (45.5%), followed by type II (17.8%) and I (17.8%) canals. Type III, V, VI, VII, and VIII canals are less than 10% in total. Seven additional canal types were seen for 10% in total. Fourteen (13.86%) distobuccal roots had multiple canals, and the predominant canal type is type I (86.1%), followed by type II (5.9%) and V (4%) canals. Three additional canal types were observed for 4% in total. All palatal roots possessed the simplest type I canal. Apical ramification occurred in 69 mesiobuccal roots (68.3%), 36 distobuccal roots (35.6%), and 37 palatal roots (36.6%). A total of 240 lateral canals were observed in 101 specimens. Each specimen had 2.38 ± 2.22 lateral canals on average. The highest incidence, 136 (56.67%) lateral canals, occurred in the mesiobuccal root, followed by 57 (23.75%) and 47 (19.58%) lateral canals from the distobuccal root and the palatal root, respectively. Each specimen had 6.17 ± 2.42 foramina. Mesiobuccal root had the highest incidence of apical foramina compared to other roots. Seventy-two mesiobuccal roots (71.29%) had isthmus, while only 7 distobuccal roots (6.93%) had isthmus somewhere along the root.

Conclusions

The root canal anatomy of BMFM was quite complex, especially in the mesiobuccal root. The predominant canal type was Vertucci type IV in the mesiobuccal root and type I in the distobuccal and palatal roots. In addition, this micro-computed tomography study disclosed complemented canal types and a higher prevalence of lateral canal than the previous studies.

Assessment of root canal morphology of mandibular permanent anterior teeth in an Iraqi subpopulation by cone-beam computed tomography

Background/purpose

Endodontic treatment is basically dependent on knowledge of the root canal anatomy. This study aimed to analyze the root canal configuration of mandibular anterior teeth in an Iraqi subpopulation using cone-beam computed tomography (CBCT) imaging.

Materials and methods

A total of 305 CBCT scans involving 1794 mandibular permanent anterior teeth were evaluated. The number of roots, root canals, root canal system configuration according to Vertucci classification, and bilateral symmetry in root number and root canal number were recorded and statistically analyzed. The effects of gender and age on the incidence of root canal morphology and root canal number were investigated. Chi-square test was used to determine the level of significance (p < 0.05) and Kappa value was used to check reliability of results of the research.

Results

Among the study patients, double root canals were found in (right 26.1% and left 26.4%) mandibular central incisors, in lateral incisors (right 28% and left 30.4%) and canines (right 11.7% and left 11%). Most teeth (77.8%) had a Type I Vertucci configuration and Type V was the least common and only present in canines (0.8%). All examined incisors presented with only one root and only around 2% of canines had two roots. Gender differences were identified for central incisors, while for lateral incisors and canines there were none. Patients older than 60 years had fewer teeth with double root canals (p < 0.05). Slight bilateral asymmetries appeared in central, lateral incisors, and canines in relation to root and root canal numbers.

Conclusion

Single rooted with Type I canal configuration is the most prevalent in mandibular anterior teeth in the Iraqi subpopulation. However, the incidence of more than one root canal with different canal configurations is also detected.

Endodontic management of a maxillary second molar with three roots and seven canals using cone-beam computed tomography

The present case highlights the endodontic management of a maxillary second molar with three roots and seven canals. Root canal treatment was performed for the maxillary second molar diagnosed with symptomatic irreversible pulpitis. During the procedure under magnification, extra canals were detected in the mesiobuccal root. Cone-beam computed tomography (CBCT) evaluation confirmed four canals in the mesiobuccal root with Vertucci's Type XXI (4-1) pattern. The distobuccal root exhibited two canals with Vertucci's Type III (1-2-1) configuration. The palatal canal was single and large. A 4 year follow-up revealed satisfactory clinical and radiographic findings. Magnification and CBCT allow us to explore possible anatomic variations with insights to tackle such situations clinically.

Root anatomy and canal configuration of human permanent mandibular second molar: A systematic review

The objective of the study was to review the literature on root anatomy and canal configuration in permanent mandibular second molar based on Vertucci classification. Online electronic databases such as PubMed-Medline, Embase, Scopus, and Cochrane Library were searched using appropriate keywords from the earliest available date till 10^th February 2021 restriction on language. Additional sources such as Google Scholar, major journals, unpublished studies, conference proceedings, and cross-references were explored. Information curated for data extraction included methodology, population, sample size (number of teeth), number of root canals, and type of root canal configuration (RCC). Thirty-seven articles were selected with a total of 12,393 permanent mandibular second molar teeth. In the mesial root, Type IV canal configuration with 37.3% was more frequent, having two canals with 70.4%. In the distal roots, one canal was more prevalent with 77% occurrence, and Type I canal configuration was more frequent with 85.2%. Comprehensive knowledge of tooth anatomy and root canal morphology is crucial to root canal treatment. Therefore, an understanding of the canal configuration and anatomy is necessary for the dentist to enhance successful endodontic treatment. Our systematic review findings reveal a wide variety of possible canal configurations among permanent mandibular second molar, while the number of canals ranged from 1 to 5 in number. The evidence is intended to help dental practitioners to avoid mishaps such as perforation and missing canals and anticipation of potential complications during treatment.

Classification and morphology of middle mesial canals of mandibular first molars in a southern Chinese subpopulation: a cone-beam computed tomographic study

Background

Cone-beam computed tomography (CBCT) was employed to study the morphology and curvature of middle mesial canals (MMCs) of mandibular first molars (MFMs).

Methods

CBCT scanning was performed on MFMs of 1100 patients. Patients' images that met the inclusion criteria were divided into group A (< 40 years old) and group B (≥ 40 years old) for further study. The images were used to study the incidence of MMCs at different ages, measure the curvature of MMCs in the mesiodistal and buccolingual directions using the Schneider method, and observe the anatomical morphology of the mesial root canal system. All statistical analyses were performed by using SPSS 21.0 software. Quantitative data were presented as mean ± standard deviation. Student’s t-test was used to calculate the statistical significance. P < 0.05 was considered statistically significant.

Results

In 875 patients, 1750 MFM images met the inclusion criteria. Among these cases, 158 MFMs contained an MMC, yielding an incidence rate of 9.03%. The incidence rate of MMCs was 11.22% in group A and 6.61% in group B, and this difference was statistically significant (P < 0.05). The curvature in the mesiodistal direction was 29.39 ± 8.53° in group A and 26.06 ± 8.50° in group B, and this difference was also significant (P < 0.05). The curved regions in groups A and B were often located in the middle 1/3 of canal. No significant difference in the distance between MMC orifices and mesiobuccal canal orifices or mesiolingual canal orifices was noted (P > 0.05). The most common mesial root canal morphological type was type II (3-2) (53.80%).

Conclusion

The incidence of MMCs in MFMs declined as age increased. The canal systems of MMCs were varied and complex, mainly exhibiting an obvious mesiodistal curve. CBCT is an outstanding method to help guide root canal therapy.

*Yeqing Yang and Buling Wu have contribute equally to this article.

The frequency of the second mesiobuccal canal in maxillary first molars among a sample of the Kurdistan Region-Iraq population - A retrospective cone-beam computed tomography evaluation

Background/purpose

One of the most complexes in root and canal anatomy is the maxillary first permanent molar. This study aimed to analyze the frequency of mesiobuccal (MB2) canal and its apical portals of exit, in patients belonging to different gender-age groups and determine the possible relation with sex and age.

Materials and methods

A CBCT scan images were accessed from a documented database of 343 patients (178 male, 165 female), who had an oral and maxillofacial examination. The age of the patients ranging from 12 to 63 years. The frequency of the MB2 canal and its portals of exit apically were observed. Age and gender correlation were calculated using the χ2 test. P < 0.05 was considered significant.

Results

A total of 634 maxillary first molars (335 male, 299 female) were included. The MB2 canal was found in 53.78% of the cases. A significantly higher incidence of the MB2 canal was detected in males than in females. No correlation in the presence and/or absence of the MB2 canal in terms of age. When MB2 canal present, a single apical foramen was observed in 66.28% of the cases, two apical foramina were present in 33.72% of the cases.

Conclusion

MB2 canals may be present in approximately half of the cases, from which one third of the cases have their own apical portal of exit.

Position of Orifice of Distobuccal Canal of Maxillary Second Molars Using Cone-Beam Computed Tomography

BACKGROUND AND OBJECTIVES

This study aimed to assess the position of distobuccal canal orifice of maxillary second molars using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

A total of 301 CBCT scans of patients were retrieved from the archives of a radiology clinic, and the distance between the orifices of distobuccal and mesiobuccal root canals, the distance between the orifices of distobuccal and palatal root canals and the angle between the orifices of mesiobuccal, distobuccal and palatal root canals in the axial plane were measured on CBCT scans.

RESULTS

Of 301 maxillary second molars evaluated in this study, 202 (67.1%) had three canals and 99 (32.9%) had four canals. The distance between the distobuccal and mesiobuccal canal orifices (DM) ranged from 1.10 to 4.40 mm (mean: 2.1831±0.6370 mm). The distance between the distobuccal and palatal canal orifices (DP) ranged from 1.20 to 6.20 mm (mean: 3.8704±0.84944 mm). The mean angle between the mesiobuccal, distobuccal and palatal orifices (MDP) was 106.37±12.12075°.

CONCLUSION

Around one-third of maxillary second molars had four canals; the rest had three canals. No maxillary second molar with two canals was found. The orifice of distobuccal canal was located at 2 mm distance from the mesiobuccal canal orifice in distopalatal direction in the majority of cases. It had 3 to 4 mm distance from the palatal canal orifice in most cases. CBCT is recommended to find the orifice of distobuccal canal in cases in whom negotiation of this canal is challenging.

Micro-computed tomography analysis of the relationship between root canal number and root concavity in maxillary first and second molars in a Japanese population

PURPOSE

The aim of this study was to investigate root canal configurations in maxillary first and second molars from a Japanese population, as well as the relationship between the root canal number and root concavity depth, using micro-computed tomography.

METHODS

Maxillary first (N = 74) and second (N = 70) molars from a Japanese population were used. Virtual horizontal sections were created, and the number of root canals and the degree of root concavity were measured. Mesiobuccal (MB) roots were categorized into Group 1 (with a single root canal) or Group 2 (with two or more root canals). The relationship between the root canal number and root concavity depth was evaluated using the Mann-Whitney U test.

RESULTS

Approximately 51% and 35% of the MB roots in the three-rooted maxillary first and second molars, respectively, had two or more root canals. The depths of the root concavities in maxillary first molars differed significantly between Groups 1 and 2 at the mesial and distal sides of the MB root, in the section 2 mm apical to the furcation area (p < 0.05).

CONCLUSIONS

A significant relationship between the number of root canals and the depth of root concavity in the MB root of the maxillary first molars was observed. Close clinical monitoring is needed during the removal of calculus and cleaning of the root surfaces of maxillary first molars: specifically, excessive removal of cementum and dentin should be avoided, particularly when the molar has already undergone root canal treatment.

Cone-beam-computed-tomography of the symmetry of root canal anatomy in mandibular incisors

This study aimed to evaluate the prevalence of internal symmetry (the number and morphology of root canals) in the mandibular incisors using cone beam computed tomography (CBCT). A total of 302 CBCT scans involving 1,208 mandibular incisors were evaluated using the Vertucci's classification regarding the number and configuration of root canals. The central mandibular incisors exhibited two root canals in 22.6% of patients and lateral incisors in 24.3% of patients. Most teeth (76.4%) had a type I configuration (a single root canal, 1-1), 21.7% had type II (2-1), 1.1% had type V (1-2), and 0.8% had type IV (2-2). Teeth with a type-III configuration (1-2-1) were not found. In total, 17.5% of patients had a symmetric appearance of the two-canalled central mandibular incisors and 20.5% had a bilateral appearance of the two-canal lateral incisors. Moreover, in 12.3% of the patients, all four incisors showed two root canals. The highest degree of symmetry was found in incisors that had one root canal (central incisors: 217 of 302, lateral incisors: 229 of 302), followed by type 2-1 incisors (central incisors 50, lateral incisors 58). The influence of sex and age on the prevalence of symmetries was not significant. Concluding, the internal anatomy of the mandibular incisors cannot not be sufficiently predicted from the root canal anatomy of the contralateral tooth. Thorough clinical and radiographic inspection of each tooth remains mandatory to address the internal anatomy of the mandibular incisors correctly.

Application of a new system for classifying root canal morphology in undergraduate teaching and clinical practice: a national survey in Malaysia

AIM

To evaluate and compare the feedback of final year undergraduate dental students in eight Malaysian dental schools on the application of a new system for classifying root canal morphology in teaching and clinical practice.

METHODS

One PowerPoint presentation describing two classification systems for root canal morphology (Oral Surgery Oral Medicine Oral Pathology, 1974 38, 456 and its supplemental configurations, International Endodontic Journal 2017, 50, 761) was delivered to final year undergraduate dental students in eight dental schools in Malaysia by two presenters (each presented to four schools). To examine students' feedback on the utility of each system, printed questionnaires consisting of six questions (five multiple choice questions and one open-ended question) were distributed and collected after the lecture. The questionnaire was designed to compare the classification systems in terms of accuracy, practicability, understanding of root canal morphology and recommendation for use in pre-clinical and clinical courses. The exact test was used for statistical analysis, with the level of significance set at 0.05 (P = 0.05).

RESULTS

A total of 382 (out of 447) students participated giving a response rate of 86%. More than 90% of students reported that the new system was more accurate and more practical compared with the Vertucci system (P < 0.001). Overall, 97% of students reported the new system helped their understanding of root and canal morphology compared with the Vertucci classification (P < 0.001). Over 97% of students recommended the use of the new system in teaching, pre-clinical courses and clinical practice (P < 0.001). Except for two schools, no significant difference was detected between the responses of students for all questions at the different schools (P > 0.05). The students' responses for all questions were almost similar for both presenters (P > 0.05).

CONCLUSIONS

The new system of International Endodontic Journal 2017, 50, 761 for classifying root and canal morphology was favoured by final year undergraduate dental students in Malaysia. The new system has the potential to be included in the undergraduate endodontic curriculum for teaching courses related to root and canal morphology.

Endodontic Management of Maxillary Second Molar Tooth with a Single Root and Single Canal

Comprehensive understanding of variations in the root canal morphology of a maxillary molar is useful for performing successful endodontic treatment in such cases. This case report describes endodontic management of a case with such aberrant root canal morphology of a maxillary second molar having a single root and single canal.

Analysis of root canal system of maxillary first and second molars and their correlations by cone beam computed tomography

BACKGROUND/PURPOSE

Understanding the root canal systems of molars and the association of root canal system in adjacent or contralateral molars is important for dental practice. This study aimed to use cone-beam computed tomography (CBCT) to analyze the morphology similarity of root canal systems in the maxillary first and second molars.

METHODS

CBCT images of 1741 maxillary molars in a total of 519 patients were blindly examined to analyze the correlation of root canal systems between maxillary first and second molars as well as the bilateral first and second molars.

RESULTS

The most common type in maxillary first molars is 3R4C (3 roots/4 canals), whereas in maxillary second molars is 3R3C.The symmetry in type of root canals in bilateral maxillary first and second molars were 87.36% and 79.85%, respectively. The similarities of root canal system in adjacent maxillary first and second molars were 53.07% (right side) and 52.58% (left side). The concurrence of MB2 canal in bilateral maxillary first molars is 77.8%, and 35.97% in maxillary second molars. In the 110 patients with MB2 canal in bilateral maxillary second molars, the chance of bilateral MB2 canals in their maxillary first molar is almost 100%.

CONCLUSION

Maxillary first molars have higher prevalence of 3R4C than second molars. The symmetry in bilateral maxillary molars is higher than the similarity in adjacent maxillary first and second molars. Application of CBCT analysis of root canal system can improve endodontic treatment outcomes. The correlation of root canal system between teeth is useful for genetic linkage.

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.

Fused roots of maxillary molars: characterization and prevalence in a Latin American sub-population: a cone beam computed tomography study

Objectives

The upper molars generally have three roots; therefore, different combinations of fusion can occur, increasing the possibility of finding more complex root canal systems. The purpose of this study was to evaluate the prevalence and characterization of fused roots in first and second maxillary molars using cone-beam computed tomography (CBCT) in a Colombian population.

Materials and Methods

A total of 1274 teeth were evaluated, of which 534 were maxillary first molars and 740 were maxillary second molars. Axial sections were made at the cervical, middle, and apical levels to determine the prevalence of root fusion and the types of fusion.

Results

Overall, 43% of the molars (n = 551) presented some type of fused root. Root fusion was present in 23.4% of the maxillary first molars. The most frequent type of fused root was type 3 (distobuccal-palatal; DB-P) (58.9%). Root fusion was observed in 57.6% of the maxillary second molars, and the most prevalent type of fused root was type 6 (cone-shaped) (45.2%). Of the maxillary molars, 12.5% were classified as C-shaped.

Conclusion

Within the limitations of this study, there was a high prevalence of fused roots in maxillary molars in the Colombian population, mainly in the maxillary second molars. In first molars, the most common type of fused root was type 3 (DB-P) and in second molars, the most common type was type 6 (cone-shaped). Additionally, molars with root fusion presented variation at different levels of the radicular portion, with implications for treatment quality.

Maxillary second molar with four roots and five canals

In this case report, we present a maxillary second molar variant, which had two palatal roots with two canals and two buccal roots with three canals, including a second mesiobuccal canal. A 44-year-old female patient complained about a tooth crown fracture and severe pain in her right maxillary second molar. A clinical intraoral inspection and radiography were carried out on the tooth, and a diagnosis of chronic apical periodontitis was made. Four roots (two buccal and two palatal) and five canals (three buccal and two palatal) were found. The anatomical variation of the tooth was further confirmed by cone-beam computed tomography, a cone-fit procedure, and a radiograph with a shifted projection angle. Root-canal treatment was performed under an endodontic microscope.

Root Canal Morphology of Maxillary Second Molars according to Age and Gender in a Selected Iranian Population: A Cone-Beam Computed Tomography Evaluation

Introduction

This study sought to assess root canal morphology of maxillary second molars regarding age and gender in an Iranian population using cone-beam computed tomography (CBCT).

Methods and Materials

Totally, 157 maxillary second molars of patients presenting to a radiology clinic were evaluated on CBCT scans. Tooth length, number of roots, root fusion, coronal and sagittal root deviation, number of canals per root, prevalence of second mesiobuccal canal, root canal morphology according to the Vertucci's classification and the correlation of these variables with age and gender were evaluated. Data were analyzed using the Mann Whitney U, Kruskal Wallis and Fisher's exact tests.

Results

Of 157 teeth, 98 belonged to females and 59 to males. The mean tooth length was significantly greater in males than in females (P=0.002) and it was shorter in 50-60 years old group. The rate of root fusion was 18.6%. Distobuccal and palatal roots were mainly straight in both sagittal and coronal planes while mesiobuccal roots mostly had a distal-buccal deviation; 67.5% of the teeth had four canals. Number of canals was significantly correlated with gender and was higher in males (P<0.05). The most prevalent canal type was type VI in second mesiobuccal, and type V in palatal and distobuccal canals. The most common types in mesiobuccal canal were types I, VI and II, respectively. In the remaining two roots, type I was the most common.

Conclusion

Root and canal morphology of the maxillary second molars in Iranian population showed features different from those in other populations.

An original micro-CT study and meta-analysis of the internal and external anatomy of maxillary molars-implications for endodontic treatment

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.

Micro-computed tomography-based anatomical study of the branch canals in mandibular anterior teeth in a Chinese population

OBJECTIVES

To analyze the incidence and distribution of branch canals in mandibular anterior teeth.

MATERIALS AND METHODS

Three hundred mandibular anterior teeth, comprising 100 central incisors, 100 lateral incisors, and 100 canines, were scanned using a micro-computed tomography (micro-CT) system. Three-dimensional (3-D) visualization reconstruction of the root canal system and its branch canals was performed on each specimen. Data regarding the number of branch canals, the distance from the anatomical apex to the branch canal, and the orientation of each branch orifice were collected and analyzed.

RESULTS

One hundred and fifty-three primary branch canals and 35 secondary branch canals were detected in the specimens overall. The incidence of branch canals in mandibular anterior teeth was 34%, with the highest incidence (50%) exhibited in mandibular canines, followed by lateral incisors (29%). Of the 153 primary branch canals found in the mandibular anterior tooth samples investigated, 82.35% appeared within 3 mm of the apical region, while 71.90% were labial and lingual canals.

CONCLUSIONS

There was regularity in the distribution and orientation of branch canals in mandibular anterior teeth.

CLINICAL RELEVANCE

This knowledge may be employed as a guide in clinical endodontic therapy.

The morphology of maxillary first and second molars analyzed by cone-beam computed tomography in a polish population

BACKGROUND

The success of endodontic treatment is greatly affected by the location of the root canals. The purpose of this study was to evaluate the root and canal morphology of permanent maxillary first and second molars in a Polish population using cone-beam computed tomography scanning.

METHODS

Cone-beam computed tomography (CBCT) scans of maxillary first and second molars the maxilla were examined. The number of roots and root canals, and the frequency of additional canals (MB2) in the mesiobuccal root canals were determined. The results were subjected to statistical analysis using the chi-square test or the chi-square test with Yates' correction.

RESULTS

A total of 112 CBCT images of maxillary first (n = 185) and second molars (n = 207) from 112 patients were analyzed. All the maxillary first molars had three roots (100%). The majority of maxillary second molars had three roots (91.8%), 5.8% had two roots and 2.4% had one root. A statistically significant difference was observed between the numbers of roots in the maxillary first and second molars (p < 0.01). A statistically significant difference was also found in the distribution of the number of canals in the maxillary first and second molars (p < 0.001). The majority of maxillary first molars had four root canals (59.5%), while 40.5% had three root canals. Most maxillary second molars had three root canals (70%). Additional canals (MB2) in the mesiobuccal roots were detected significantly more frequently in the maxillary first molars than the second molars (p = 0.000) and more frequently in men than in women (p < 0.05). A higher prevalence of two canals in the mesiobuccal roots in maxillary second molars occurred in patients aged between 31 and 40 years than in patients aged between 21 and 30 years. In the maxillary first molars, the prevalence of the MB2 canal in the mesiobuccal root was almost equally distributed in the two age groups (21-30 and 31-40 years).

CONCLUSION

Within the limitations of this study, it can be concluded that there are differences in the number and configuration of roots and root canals between maxillary first and second molars in the studied patients of a Polish population.

Advantages and Applications of a New System for Classifying Roots and Canal Systems in Research and Clinical Practice

OBJECTIVE

A new coding system for classifying the roots, main and accessory canals as well as developmental anomalies has been introduced recently. This paper discusses the advantages and potential application of the new system in research and clinical practice.

METHODS

A comprehensive analysis was undertaken on the most common, existing classification for root canal morphology. The advantages and potential applications of a new system for classifying roots and canal systems in research and clinical practice are discussed.

RESULTS

The analysis demonstrates deficiencies of the existing classification including lack of information on the number of roots, pulp chamber outline, lack of clarity in multi-rooted teeth, inability to define complex root canal configurations. The new coding system addresses the root and canal morphology in an accurate and systematic manner to provide detailed information of the tooth, root and canal anatomical features.

CONCLUSION

With current advances in endodontic research and practice and the increasing body of knowledge on root and canal morphology, the deficiencies of the existing system used for classifying root canal morphology have become more apparent. The new system for classifying root, main and accessory canal morphology as well as teeth with anomalies has the potential to be used in research, clinical practice and education to accurately reflect the real anatomy of a tooth.

A Cone-beam Computed Tomographic Study of Root and Canal Morphology of Maxillary First and Second Permanent Molars in a Thai Population

INTRODUCTION

Understanding tooth anatomy is crucial for effective endodontic treatment. This study investigated the roots and root canal morphology of maxillary first and second permanent molars in a Thai population using cone-beam computed tomographic (CBCT) imaging.

METHODS

This study evaluated 476 maxillary first molars and 457 maxillary second molars receiving CBCT examination and determined the number of roots and canal morphology according to Vertucci's classification, and the prevalence of a second mesiobuccal (MB2) canal in the mesiobuccal (MB) root was correlated with sex, age, and tooth side.

RESULTS

Three roots were most commonly found in maxillary first and second molars. MB2 canals in the MB root were found in 63.6% and 29.4% of first and second molars, respectively. The most common canal morphology in the first molar MB roots was type I (36.4%) followed by type II (28.8%), and type IV (25.3%). The most common canal morphology in the second molar MB roots was type I (70.6%) followed by type II (14.6%) and type IV (7.5%). Bilateral MB2 canals in the MB roots were present in 80.93% and 82.59% of the first and second molars, respectively. There was a significant correlation between males and the prevalence of MB2 canals in first molars (P < .05).

CONCLUSIONS

CBCT imaging is useful to determine root canal morphology. The prevalence of MB2 canals is approximately 60% and 30% in first and second molars, respectively. Furthermore, bilateral MB2 canals were commonly found. Our results can help endodontists to improve endodontic treatment outcomes.

Maxillary First Molars with 2 Distobuccal Canals: A Case Series

An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar.

Evaluation of the root and canal systems of maxillary molars in Taiwanese patients: A cone beam computed tomography study

Background

This study evaluated variations in root canal configuration in the maxillary permanent molars of Taiwanese patients by analyzing patients' cone beam computed tomography (CBCT) images. Comparisons were made among these configurations and those previously reported. This information may serve as a basis for improving the success rate of endodontic treatment.

Methods

The root canal systems of 114 Taiwanese patients with bilateral maxillary first or second molars were examined using CBCT images. The number of roots, canals per root, and additional mesiobuccal (MB) canals, as well as the canal configuration were enumerated and recorded.

Results

Of the 196 maxillary first molars examined, three (1.5%) had a single root, two (1.0%) had two roots, and 191 (97.5%) had three separate roots. Out of all first molar roots examined, 44% of mesiobuccal (MB) roots had a single canal and the remainder had a second MB (MB2) canal. Of the 212 maxillary second molars examined, 16 (7.1%) had a single root, 51 (24.2%) had two roots, 143 (67.8%) had three roots, and two (0.9%) had four separate roots. For the MB roots, 92.3% of three-rooted maxillary second molars had a single canal and the remainder had an MB2 canal. In all three-rooted maxillary first and second molars, each of the distal and palatal roots had one canal.

Conclusions

The root canal configurations of the MB roots of maxillary molars were more varied than those of the distobuccal and palatal roots, and the root canal configurations of maxillary second molars were more varied than those of the first molars. These findings demonstrate CBCT as a useful clinical tool for endodontic diagnosis and treatment planning.

Evaluation of Root and Canal Morphology of Maxillary Permanent Molars in an Egyptian Population by Cone-beam Computed Tomography

INTRODUCTION

The purpose of this study was to evaluate the number of roots and canal morphology of maxillary permanent molars in an Egyptian population.

METHODS

Six hundred fifty-seven cases were included in this study. Digitized images from cone-beam computed tomographic scanning were assessed by 2 endodontists. The number of roots and canal configuration according to Vertucci were tabulated. Age, sex, and bilateral distribution differences were calculated.

RESULTS

All maxillary first molars showed 3-root configuration, whereas maxillary second molars showed 3-, 2-, and single-root configurations. For maxillary first molars, the most common Vertucci classifications for the mesiobuccal root were type II (2-1, 45.6%), type IV (2-2, 27.27%), and type I (1, 25.45%). For maxillary second molars, the most common Vertucci classifications for the mesiobuccal root were type II (2-1, 47.1%), type I (1, 42.06%), and type IV (2-2, 8.03%). The prevalence of a second mesiobuccal canal is statistically not affected by either sex, tooth position (right or left side), or age.

CONCLUSIONS

Under the conditions of this study, the root canal configurations of an Egyptian population showed that the most common Vertucci classifications for the mesiobuccal root for maxillary first molars were type II (2-1), type IV (2-2), and type I (1). For maxillary second molars, the most common types were type II (2-1), type I (1), and type IV (2-2). Pre-evaluation of the endodontic case using cone-beam computed tomographic digital imaging provides better information of root canal morphology, which might improve the management and prognosis of the case.

Interrelationships in the Variability of Root Canal Anatomy among the Permanent Teeth: A Full-Mouth Approach by Cone-Beam CT

Objectives

In endodontic practice, clinicians should be aware of possible root canal anatomic variations. The aim of this study was to assess using CBCT acquisitions regarding whether one root canal anatomy of a tooth is associated with a specific anatomy of another tooth.

Methods

A total of 106 CBCT acquisitions were obtained using a CBCT scanner with 200μm voxel size. Numbers of roots and canals of the entire dentition were described. Bivariate analyses and logistic regressions were conducted to explore root canal anatomy on one tooth according to age, gender, jaw, side and the others teeth. Multiple correspondence analysis (MCA) was performed to correlate the different numbers of canals profiles.

Results

A total of 2424 teeth were analyzed. Independently from the other variables, the presence of an additional root canal on a mandibular incisor increases the risk of having an additional root canal on a mandibular premolar (OR _[95%] 3.7 [1.0;13.2]). The mandibular molar variability increases in women compared to men (OR _[95%] 0.4 [0.1; 0.9]). MCA showed correspondence between 2-canals maxillary incisor and canines and 5-canals maxillary molars, and some correlation between additional canal on maxillary and mandibular premolars.

Conclusions

Although CBCT examinations are conducted in the first intention of making a diagnosis or prognostic evaluation, medium FOV acquisitions could be used as an initial database thus furnishing preliminary evaluations and information. In endodontic practice, clinicians should be aware of possible root canal anatomic variations. The visualization of all canals is considered essential in endodontic therapy. The use of multi-correspondence analysis for statistics in endodontic research is a new approach as a prognostic tool.

Retrospective study of root canal configurations of maxillary third molars in Central India population using cone beam computed tomography Part- I

Objective:

The aim of this study was to investigate the root and canal morphology of maxillary third molars in Central India population using cone-beam computed tomography (CBCT) analysis.

Materials and Methods:

CBCT images of 116 maxillary third molars were observed, and data regarding the number of roots, the number of canals, and Vertucci's Classification in each root was statistically evaluated.

Results:

Majority of Maxillary third molars had three roots (55.2%) and three canals (37.9%). Most MB root (43.8%), DB root (87.5%), and palatal root (100%) of maxillary third molars had Vertucci Type I. Mesiobuccal root of three-rooted maxillary third molars had Vertucci Type I (43.8%) and Type IV (40.6%) configuration. Overall prevalence of C-shaped canals in maxillary third molars was 3.4%.

Conclusion:

There was a high prevalence of three-rooted maxillary molars with three canals.

Analysis of the Root and Canal Morphologies in Maxillary First and Second Molars in a Chinese Population Using Cone-beam Computed Tomography

INTRODUCTION

We analyzed and characterized the root and canal morphologies in maxillary first and second molars in a large sample of Chinese patients using reconstructed cone-beam computed tomographic (CBCT) imaging.

METHODS

Maxillary first (n = 1558) and second (n = 1539) molars were collected from Chinese patients (N = 844) who had undergone in vivo CBCT imaging. The root canal number and morphology were determined according to Vertucci's classification.

RESULTS

A single root was found in 0.06% of first molars, which showed type I canal systems. However, second molars with a single root (4.2%) showed widely varied canal systems. The buccal roots of first molars with 2 separate roots showed type I, II, or III canal systems, whereas those of 2-rooted second molars showed widely varied canal systems. The incidence of fused roots was 1.38% for first molars and 23.9% for second molars, whereas canal fusion within fused roots was observed in 4.5% of first molars and 10.6% of second molars. Additional canals were observed in 67.8% and 29.7% of mesiobuccal roots, 1.8% and 0.7% of distobuccal roots, and 0.7% and 0.3% of palatal roots in 1523 and 1017 first and second molars with 3 separate roots, respectively. The mesiobuccal root canal number showed bilateral symmetry between 79% of first molars and 82.3% of second molars, with a concurrence rate of 59.8% between adjacent molars.

CONCLUSIONS

We reported the root and canal morphologic variations in maxillary first and second molars, which have not been reported for Chinese populations. Further studies should focus on canals in fused roots and mesiobuccal roots.

Analysis of C-shaped root canal configuration in maxillary molars in a Korean population using cone-beam computed tomography

OBJECTIVES

The purpose of this study was to investigate the incidence of root fusion and C-shaped root canals in maxillary molars, and to classify the types of C-shaped canal by analyzing cone-beam computed tomography (CBCT) in a Korean population.

MATERIALS AND METHODS

Digitized CBCT images from 911 subjects were obtained in Chosun University Dental Hospital between February 2010 and July 2012 for orthodontic treatment. Among them, a total of selected 3,553 data of maxillary molars were analyzed retrospectively. Tomography sections in the axial, coronal, and sagittal planes were displayed by PiViewstar and Rapidia MPR software (Infinitt Co.). The incidence and types of root fusion and C-shaped root canals were evaluated and the incidence between the first and the second molar was compared using Chi-square test.

RESULTS

Root fusion was present in 3.2% of the first molars and 19.5% of the second molars, and fusion of mesiobuccal and palatal root was dominant. C-shaped root canals were present in 0.8% of the first molars and 2.7% of the second molars. The frequency of root fusion and C-shaped canal was significantly higher in the second molar than the first molar (p < 0.001).

CONCLUSIONS

In a Korean population, maxillary molars showed total 11.3% of root fusion and 1.8% of C-shaped root canals. Furthermore, root fusion and C-shaped root canals were seen more frequently in the maxillary second molars.

Root Canal Morphology and Configuration of 179 Maxillary First Molars by Means of Micro-computed Tomography: An Ex Vivo Study

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.

Evaluation of the Root and Canal Morphology of Maxillary Permanent Molars and the Incidence of the Second Mesiobuccal Root Canal in Greek Population Using Cone-beam Computed Tomography

Objectives: Cone-Beam Computed Tomography is an alternative imaging technique which has been recently introduced in the field of Oral &amp; Maxillofacial Radiology. It has rapidly gained great popularity among clinicians due to its ability to detect lesions and defects of the orofacial region and provide three-dimensional information about them. In the field of Endodontics, CBCT can be a useful tool to reveal tooth morphology irregularities, additional root canals and vertical root fractures. The objective of this study is to evaluate the root and root canal morphology of the maxillary permanent molars in Greek population using Cone-Beam Computed Tomography. Materials and Methods : 273 cone-beam computed tomography (CBCT) images were examined. The number of roots and root canals of the first and second maxillary molars were evaluated. Root canal configuration was classified according to Weine’s classification by two independent examiners and statistical analysis was performed. Results : A total of 812 molars (410 first and 402 second ones) were evaluated. The vast majority of both first and second molars had three roots (89.26% and 85.07%, respectively). Most first molars had four canals, while most second molars had three. In the mesiobuccal roots, one foramen was recorded in 80.91% of all teeth. Other rare morphologic variations were also found, such as fusion of a maxillary second molar with a supernumerary tooth. Conclusion : Within the limitations of this study, it can be concluded that more attention should be given to the detection of additional canals during root canal treatment in maxillary permanent molars. Towards this effort, CBCT can provide the clinician with supplemental information about the different root canal configurations for successful Root Canal Treatment.

Root and Root Canal Morphology of Human Third Molar Teeth

Successful root canal treatment depends on having comprehensive information regarding the root(s)/canal(s) anatomy. Dentists may have some complication in treatment of third molars because the difficulty in their access, their aberrant occlusal anatomy and different patterns of eruption. The aim of this review was to review and address the number of roots and root canals in third molars, prevalence of confluent canals in third molars, C-shaped canals, dilaceration and fusion in third molars, autotransplantation of third molars and endodontic treatment strategies for third molars.