Cone-beam computed tomography study of the root and canal morphology of mandibular permanent anterior teeth in a Chongqing population

Root canal morphology of mandibular anterior permanent teeth in Turkish sub-population using two classification systems: a cone-beam computed tomography study

This study examined the root and canal morphology of mandibular anterior teeth (MA) in the Turkish sub-population using cone-beam computed tomography (CBCT), comparing the findings based on Vertucci's and Ahmed et al. classification systems. The CBCT images were acquired using the 3D Accuitomo CBCT device. Images that were deemed suitable for visualizing the roots, canals, and the complete pulp chamber and apex were included in the study. Vertucci and Ahmed et al. classification systems were employed to determine the root canal morphology. 500 CBCT images and 3000 teeth were analyzed. Type I (1MA1) was the most frequent, followed by Type III (1MA1-2-1). 3.8% of teeth could not be classified with Vertucci system. In canine teeth, Vertucci type III (1MA1-2-1) was significantly more prevalent in males than females (p = 0.038) and Type I (1MA1) was less frequent in individuals aged 41-50 (p < 0.05). Canal divergence/merging was the most common at the middle/apical level for central (15.5%) and lateral (10.3%) teeth, and at the coronal/middle level for canine teeth (1.9%). Bilateral similarity was high for all tooth groups (> 78%). One-third of mandibular incisor teeth have two canals, with a significant number exhibiting canal divergence/merging that was separated in the middle region and merged in the apical region. The Vertucci classification was found to be inadequate in some cases, while Ahmed et al. classification was able to classify all mandibular incisors with a single code. Ahmed et al. classification is a more useful system for classifying all MA.

Classifying the internal anatomy of anterior teeth in the Yemeni population using two systems: a retrospective CBCT study

A precursor for effective root canal treatment (RCT) is a complete understanding of the internal anatomy of teeth. In this study, the authors aimed to classify the root canal morphology of anterior teeth in the Yemeni population and identify gender-based variations among them. In addition, the symmetry among adjacent quadrants was also evaluated. Cone beam computed tomography (CBCT) scans of 2935 anterior teeth, 1502 maxillary, and 1433 mandibular were analyzed for root canal morphology and symmetry. Comparison between groups and among different genders was done using the Chi-square test. All the maxillary teeth were single-rooted and had a predominantly 1TN1 (Vertucci Type I) canal morphology. In addition to 1TN1, the presence of 1TN1-2-1 (Vertucci type III) and 1TN1-2-1-2-1 (not classified NC according to Vertucci) morphologies were noticed in the maxillary canines. Among the mandibular anteriors, the canal morphologies identified include 1TN1 in majority of the scans followed by 1TN2-1 (Vertucci II), 1TN1-2-1, 1TN1-2 (Vertucci V), 1TN1-2-1-2 (Vertucci VII) was seen only in incisors and newer canal types like 1TN2-1-2-1 (NC Vertucci) and 1TN1-2-1-2-1 (NC Vertucci) was seen in canines and lateral incisors. Two roots were only seen in the mandibular canines and classified as 2TN1-2 (NC Vertucci). Variations in root and root canal morphologies were seen among both genders. However, the results were not significant. All the maxillary teeth except 0.8% were bilaterally symmetrical. In mandible, symmetry ranged between 84.5 and 86.5%. In conclusion, single-rooted teeth with 1TN1 classification are most commonly seen in all the anterior teeth. Gender-based differences were non-significant, and bilateral symmetry was high. Ahmed et al. classification could precisely represent the root canal morphology in two rooted teeth.

Evaluation of root and root canal morphology of mandibular and maxillary canine teeth in Turkish subpopulation by cone beam computed tomography with using two classification systems

BACKGROUND

Knowledge of root and canal morphology is a prerequisite for effective nonsurgical and surgical endodontic treatments. The aim of this cone beam computed tomography (CBCT) study was to evaluate the root canal morphology of permanent canines in a Turkish subpopulation using two classification systems.

METHODS

A total of 2,000 canine teeth were examined. The number of roots was identified, and root canal configurations were classified according to Vertucci's classification and a new system for classifying root and canal morphology. Fisher's exact test was used for statistical analysis, and the level of significance was set at 0.05 (p = 0.05).

RESULTS

The canal configuration type I was the most common in all canines, while type III was the second most common. According to the new system, the code 1C1-1 was the most common, whilst 1C1 (A1) codes were the second most common for all canines. In this study, more than 10% morphology that did not fit the Vertucci classification was detected. In the categorization of accessory canals based on the new classification, the most common type in all canines was 1C1,1 (A1). Age had an effect only on the morphology of the left maxillary canine (p < 0.05).

CONCLUSION

Canines in the Turkish subpopulation showed a relatively high degree of variation in root and canal anatomical variations. Clinicians should be aware of where canals converge or diverge to avoid missing canals. The new system for classifying canal morphology describes root and canal configurations more accurately and practically compared to the Vertucci classification.

Characterizing the Root Canal Configuration of Mandibular Incisors in a Western Saudi Arabian Sub-population Using Cone Beam Computed Tomography

Aim This study aimed to explore the morphology and complexity of mandibular anterior teeth in a Western Saudi Arabian sub-population using cone beam computed tomography (CBCT). Methodology CBCT scans from 818 patients were evaluated, and 3193 mandibular anterior teeth were analyzed for the number of roots, canal, canal configurations, separation level, bilateral symmetry, and gender associations. Results The results showed that all examined central and lateral incisors had a single root, and the majority exhibited a single canal. The prevalence of two canals in mandibular central and lateral incisors was 20.1% and 23.2%, respectively, resulting in an overall prevalence of 21.7% for two root canals in mandibular anterior teeth. The separation level of the two canals was predominantly located in the middle third of the root. Type I canal configuration was the most common, followed by type III. A high degree of bilateral symmetry in the number of canals and canal configurations was noted. Conclusion The findings contribute to the understanding of root canal anatomy in the Saudi population and provide valuable information for endodontic treatment planning.

Cone-beam Computed Tomography Analysis of the Root Canal Morphology of Mandibular Incisors Using Two Classification Systems in a Spanish Subpopulation: A Cross-Sectional Study

OBJECTIVE

This study evaluated the root and canal morphology in permanent mandibular incisors teeth using cone-beam computer tomography imaging in a Spanish subpopulation, and compared these findings with ipsilateral (similarity) and contralateral (symmetry) incisors. In addition, the position of canal splitting was measured.

METHODS

A total of 229 datasets comprising four mandibular teeth each (n=916 incisors) were analysed using Vertucci and Ahmed et al. classifications, and, the similarity and symmetry were calculated. The distance from the cemento-enamel junction (CEJ), and the most coronal canal divergence was measured (if present). The role of sex was also assessed. The Cochran Q Test, LOGIS PROC in SUDAAN, Chi-square, and Kappa were used for the different comparisons. A p-value of less than 0.05 was considered significant.

RESULTS

All incisors were single-rooted and no significant differences regarding root canal morphology were found according to the sex of the subjects included in the database. The most common morphology was Vertucci type I/Ahmed et al. 1MI1(65.3% for central and 66.8% for lateral incisors respectively), followed by type III/1MI1-2-1 (31% for central and 30.6% for lateral incisors). 1.8% of the samples were considered as non-classifiable with Vertucci but were classified with codes using the Ahmed et al. system. Similarity values were 74.7% for the left side, and 74.2% for the right side, whereas symmetry values were 90% for central and 84.3% for lateral incisors. In the presence of divergences, the main (SD) distances from the CEJ were for type II/1MI1-2-1 3.8+-0.8 (centrals) 4.0+-0.7 mm (laterals); for type V/1MI1-2 this value ranged between 6.0+-1.8 and 5.5+-1.5 mm, whereas values for 1MI1-2-3-2-1 were 1.8 and 2.1 mm. No significant differences were found when the position of the most coronal divergence was compared between lateral and central incisors for the different morphologies.

CONCLUSION

A high prevalence of Vertucci I/Ahmed et al. 1MI1 configuration was present in mandibular incisors from Spanish individuals. Similarity and symmetry were common, particularly for central incisors. The position of the coronal splitting of the canals varied according to the root canal morphology.

Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study

BACKGROUND

Adequate knowledge of root canal morphology and its variation is essential for success of root canal treatment and to overcome treatemnt failure. The aim of this study was to investigate the root and canal morphology of mandibular anterior teeth using 2 classification systems.

METHODS

3342 lower anteriors were evaluated from 557 CBCT scans. The images were examined in sagittal, axial and coronal views using a CS 3D imaging software (V3.10.4, Carestream Dental). Demographic data recorded, the number of roots and canal's morphology were described according to Vertucci and Ahmed classifications.

RESULTS

Frequency of Type I configuration was significantly the highest in incisors and canines (76%, N = 2539), followed by Type III (20.6%, N = 687). Type II (1.1%, N = 37), IV (1.1%, N = 37), and V (0.3%, N = 11) were rarely encountered. 0.9% (N = 31) of the teeth could not be classified with the Vertucci System. The frequency of 2 roots (2MA in Ahmed classification) which has no correspondence in the Vertucci classification, was 1.1% (N = 38), it was significantly higher in canines and in females (35 canines and 3 laterals). A moderate correlation in root canal morpology was found between the left and right sides (V > 0.30). 80% (N = 2538) of the teeth did not exhibit any divergence/merging. The bifurcation level occurred mostly in the middle third of the root.

CONCLUSIONS

One fourth of anterior teeth had variation from the simple type I canal configuration and therefore requires attention during treatment. The new classification system offers a more accurate and simplified presentation of canal morphology.

CLINICAL RELEVANCE

The prevalence and mid root bifurcation of second canal in lower anteriors requires attention to ensure adequate quality root canal treatment without compromising the integrity of teeth.

Analysis of Root Canal Characteristics in Permanent Canine Teeth Among 270 Saudi Subjects: A Cone-Beam Computed Tomography Study

BACKGROUND An understanding of root canal morphology is vital for successful endodontic treatment. However, variations in the root canal system of permanent canines, especially in relation to population-based diversity, are not well-documented. This study thus aimed to analyze the root canal numbers, configurations, and bilateral symmetry in 1080 permanent canine teeth among 270 Saudi individuals using cone-beam computed tomography (CBCT), contributing to the existing body of knowledge and aiding clinicians in devising effective treatment strategies. MATERIAL AND METHODS The CBCT images of 270 participants, encompassing 1080 canines (540 pairs of upper and lower canines), were scrutinized for root and canal counts. Canal configurations were assessed based on Ahmed's and Vertucci's classifications. Bilateral symmetry in these parameters was recorded and the data were statistically analyzed. RESULTS The study revealed variable prevalence of multiple roots and canals in maxillary and mandibular canines. Ahmed's and Vertucci's type I canal configuration was predominantly observed. Notably, significant bilateral symmetry was noted in root and canal numbers, and canal configurations. CONCLUSIONS The most common configuration of permanent canines was a single root and canal, usually adhering to Ahmed's and Vertucci's type I classification. Mandibular canines showed a higher incidence of two canals than two roots. The extent of bilateral symmetry, especially in mandibular canines, could provide valuable insights for better contralateral tooth treatment planning.

Morphological analysis of anterior permanent dentition in a Chinese population using cone-beam computed tomography

PURPOSE

Morphological analysis of permanent anterior dentition is essential for achieving an ideal treatment outcome and avoiding unnecessary failure. This study aimed to analyze the morphologies of anterior teeth in the Chinese population in depth.

METHODS

In this retrospective study, 4309 anterior teeth from 401 Chinese patients were investigated using cone-beam computed tomography (CBCT) from 2019-2021. We summarized the morphological characteristics of the anterior teeth in terms of the root length, cementoenamel junction curvature (CEJ-C), root furcation and canal variations.

RESULTS

We found that the root lengths of the maxillary anterior incisors were similar (13.3 mm), while the root lengths of the mandibular central (12.2 mm) and lateral incisors (13.4 mm) varied significantly (p < .0001). Both the maxillary (16.6 mm) and mandibular canines (15.5 mm) were found to have greater root lengths than the corresponding incisors (p < .0001). The CEJ-C was significantly greater around incisors (2.5 mm) than around the canines (2.0 mm) in the maxilla (p < .0001), while the curvature remained similar in mandibular anterior teeth (1.8 mm). Root furcation was observed in mandibular canines and lateral incisors. Moreover, all types of Vertucci's classification in anterior dentitions were observed, while two other new types were found. Among them, the maxilla was only observed to exhibit types I, II, III, and ST II, while the mandible was found to exhibit almost all types. However, Type I still accounts for the majority of dentitions.

CONCLUSIONS

Morphological analysis of permanent anterior dentition revealed diversity in the tooth length, CEJ-C, furcation proportion, and canal variations. In general, mandibular anterior teeth showed a more complex structure than maxillary teeth.

Endodontic Management of a Maxillary Central Incisor with two Roots: A Case Report and Literature Review

Maxillary incisors are typically straightforward cases for root canal therapy. While it is commonly assumed that maxillary central incisors have a single root canal, they may occasionally exhibit variations in their root canal system anatomy. In this report, we present a case of a maxillary central incisor with multiple root canals and provide a review of relevant literature on this anatomical variation. A 13-year-old female with deep carious lesion in tooth 11 was admitted in Department of Endodontics. Following a precise clinical and radiographic examination, a maxillary central incisor with necrotic pulp and chronic apical periodontitis along with unusual root anatomy was found and considered for non-surgical root canal treatment. Successful treatment results depend on various factors and awareness of root canal system anatomy is one of them. Due to an increasing number of reported cases of maxillary central incisors with different anatomy, it is imperative to consider anatomical variations even in the most routine cases.

Root Morphology and Canal Configuration of Permanent Canines Among Saudi Population: Systematic Review and Comparison with Worldwide Studies

Aim

The root morphology and canal configuration (RMCC) of mandibular and maxillary canines among Saudi population is systematically reviewed and compared with international studies in this research.

Methods

This study was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The electronic databases of PubMed, Science Direct, Scopus, Wiley Library, Google website search, and Web of Science were searched. Only local and international cross-sectional, comparative, evaluation, and validation studies or case reports published between 2016 and 2022 that directly evaluated canine RMCC and assessed participants using cone beam computed tomography were included.

Results

Forty-three studies that investigated RMCCs (17 local and 26 international) were involved in this review. The original Saudi research recorded that almost 100% of maxillary canines had one root and one canal, whereas 98.4% and 94.1% had one root and one canal in the mandibular arch. Vertucci's class I had the highest percentages in the maxillary and mandibular arches at 98.3% and 95.8%, respectively, followed by class III with 0.7% and 1.9% for the same arches, respectively. International studies recorded that 100% of maxillary canines had one canal and root; the percentages of the mandibular arch were 92.3 and 98% for single canal and root, respectively; and the highest percentage was obtained by Vertucci's class I (91.1%), followed by class III (4.7%).

Conclusion

This review reports and confirmed the symmetry of the RMCCs of maxillary and mandibular canines between Saudi studies and other populations. Moreover, Vertucci's classes I and III were the most frequent RMCCs, and two-rooted canines in both arches were considerably less frequently than single-rooted ones.

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.

Root Canal Morphology and Configuration of the Mandibular Canine: A Systematic Review

The aim of this study was to systematically review the root canal morphology and configuration (RCC) of mandibular canines (MaCa). The review was registered in the PROSPERO database (ID-272297) and it was carried out following the PRISMA guidelines. Three electronic databases (MEDLINE via PubMed, Embase, Scopus) were searched. Randomized controlled trials, cross-sectional, cohort, comparative, evaluation and validation studies have been included. The anatomical quality assessment (AQUA) tool was used for a quality assessment of the anatomical studies. Of 910 studies retrieved from the systematic search, 28 studies investigating RCCs were included. Most MaCa were single-rooted (87.9-100%), while two-rooted MaCa were present up to 12.1%. The 1-1-1/1 (35.8-96.4%) was the most commonly reported RCC, followed by 2-2-1/1 (0.2-22.0%) and 1-2-1/1 (0.9-20.0%). A high frequency of 1-1-1/1 RCC in MaCa has been described. Most systematic review reports confirm that two-rooted MaCa are found considerably less frequently than single-rooted ones.

Interpretation of Root Canal Anatomy of Maxillary and Mandibular Permanent Canines in Saudi Subpopulation: A Cone-Beam Computed Tomography (CBCT) Study

The objective of this investigation was to evaluate the root canal anatomy of permanent canines in a Saudi subpopulation utilizing CBCT. A total of 1328 CBCT images of maxillary (634) and mandibular (694) permanent canines were collected from Saudi patients who visited the College of Dentistry at King Saud University in Riyadh. The images were analyzed for root and canal numbers, canal configuration types, and symmetry between the bilateral canine teeth in each arch. Gender, age, and tooth position were recorded. The Kappa test was used for both inter- and intraexaminer reliabilities. Data were analyzed with the chi-square test at a P value ≤ 0.05. There were no two-rooted teeth in maxillary canines, and 1.89% had two canals. Double roots and double canals in mandibular canines were found in 2.88% and 9.94% of the teeth, respectively. Type I canal configuration was more common in maxillary canines (97.94%) compared to mandibular canines (92.07%). Maxillary canines showed higher bilateral symmetries of root and canal numbers and canal configuration types (100%, 98.1%, and 97.9%, resp.) compared to mandibular canines (97.1%, 90.1%, and 92.1%, respectively). The majority of maxillary and mandibular canines had a single root with a single canal and type I canal configuration. Mandibular canines are characterized by having more than one root and canal and alterations in root canal configurations compared to maxillary canines.

Evidence of Second Canal between Permanent Mandibular Central and Lateral Incisors in China; a Systematic Review on CBCT Studies

Introduction

Evidence of second canal in permanent mandibular incisors is frequently questioned in dentistry. The difference in evidence between the two teeth is an interesting argument across different countries and ethnicities. So the aim of the systematic review was to investigate the evidence of second canal between permanent mandibular central and lateral incisors in China.

Materials and Methods

The papers were selected from the electronic databases and hand searching according to inclusion and exclusion criteria. All qualified studies were judged by the reviewers. The selected studies were checked with Joanna Briggs Institute Critical Appraisal tool for prevalence studies. Finally, three studies were selected for the review and meta-analyses. The proportion of the second canal with its confidence interval and forest plot for the meta-analyses were calculated.

Results

The evidences of second canal in permanent mandibular central and lateral incisors in China were 5.6% and 14.1%. Only one study reported bilateral symmetry of the second canal as 58.7% and 76.1% in the two types of teeth. Out of all canal anatomies, Vertucci's type ΙΙΙ was dominant comprising 4.1% and 11.2% together with other second-canal types comprising 1.4% and 3% in permanent mandibular central and lateral incisors. When the proportions were meta-analyzed, mandibular central incisors had been less numerous OR = 0.35 [0.31, 0.40], 0.33[0.28, 0.39], and 0.42 [0.22, 0.79] in the evidence of second canal, of Type ΙΙΙ, and of other types except Type ΙΙΙ than mandibular lateral incisors in China. Out of all second-canal anatomies, Type ΙΙΙ presented 72.5% and 78.9% along with other second-canal types comprising 24.3% and 21.1% in the two teeth in China. Discussion. There was the evidence of second canal which deviated toward the permanent mandibular lateral incisor also in case of bilateral symmetry, the prevalence of Vertucci's Type ΙΙΙ, and other second-canal types out of all canal anatomies.

Root Canal Morphology of the Permanent Mandibular Incisors by Cone Beam Computed Tomography: A Systematic Review

Knowledge of dental anatomy through the assessment of the anatomic variations of each tooth’s root canal system is essential to undertake endodontic therapy. The aim of this systematic review was to analyze the different studies on the internal morphology of permanent mandibular incisors where Cone-Beam Computed Tomography (CBCT) X-ray imaging is used. Pubmed, CENTRAL, Wiley Library and Web of Science electronic databases were searched for scientific studies included until March 2020. The terms used in the search were: “permanent mandibular incisors”, “root canal morphology” and “cone-beam computed tomography”. The search was limited to studies whose aim was the analysis of the morphology of the root canal system evaluating the parameters of methodology, population, sample, number and configuration. A total of 19 studies met the inclusion criteria. There was a noticeable lack of unanimity in the setting adjustments of each of the CBCT devices used. The presence of two root canals varied from 0.4% to 45%. The most frequent configurations were Vertucci’s Types I, III, II, V, IV, VII and VI. Type VIII configuration was non-existent. CBCT revealed the existence of anatomical symmetry patterns, and there was no unanimity of criteria regarding the presence of a second root canal. Results concerning the presence of a second root canal in the mandibular incisors differ widely, with a possible influence of the geographic area where the study was conducted. The prevalence of a second canal is higher in mandibular lateral incisors than in mandibular central incisors. There was no direct relationship between voxel size (0.125–0.3 mm) and increased prevalence of a second canal.

Root and Canal Morphology of Maxillary Teeth in an Iranian Subpopulation Residing in Western Iran Using Cone-Beam Computed Tomography

Introduction

Accurate information regarding the morphology of roots and canals is a prerequisite for successful endodontic treatment. This study aimed to assess the number of roots and canals and canal type of maxillary teeth according to the Vertucci's classification in an Iranian subpopulation residing in Western Iran using cone-beam computed tomography (CBCT).

Methods and Materials

In this cross-sectional study, a total of 1750 teeth were evaluated on CBCT scans taken for purposes other than this study. For each tooth, 250 axial, sagittal and coronal sections with 1 mm slice thickness were evaluated using NNT Viewer software. The number of roots and canals and canal type according to the Vertucci's classification were determined and reported. Data were analyzed using descriptive and analytical statistics via Fisher's exact test and Chi square test. All data analyses were performed using SPSS version 18.

Results

All of the maxillary anterior teeth were single-rooted, and Vertucci's type I was the most common canal type. Maxillary premolars were mostly single-rooted and Vertucci's type I was the most common type except for the first maxillary premolars, in which type V had the highest frequency. Maxillary molars mostly had three roots and two canals in the mesiobuccal root and one canal in the distobuccal and palatal roots.

Conclusion

Although the number of roots in this cross-sectional study was similar to the findings of previous studies, canal type was significantly different from the results of previous studies. The result of this study can help clinicians in efficient root canal treatment of teeth.

Complicated Root Canal Morphology of Permanent Mandibular Lateral Incisors is Associated with the Presence of a Second Mesiobuccal Canal in Permanent Maxillary First Molars

Many studies have been conducted in order to define the root canal morphology based on age, gender, ethnic and racial characteristics of the population. However, relations within morphological variations of certain groups of teeth have rarely been investigated. The aim of this study was to evaluate the root canal morphology of mandibular lateral incisors and to determine the association between their morphologic characteristics and the presence of a second mesiobuccal canal of maxillary first molars. Cone-beam computed tomography images from a pre-existing base were analyzed for the bilateral presence of both permanent mandibular lateral incisors and permanent maxillary first molars. Root canal morphology was analyzed according to the Vertucci classification. Associations of root canal morphologies between incisors and molars were calculated as probabilities using binary logistic regression analysis. In total, 126 mandibular lateral incisors and 126 maxillary first molars were included. 46% of all mandibular lateral incisors showed complicated root canal morphology and Vertucci type III canal configuration as the most frequent. Second mesiobuccal root canal was present in 62.7%. Root canal morphologies showed high level of bilateral symmetry in both tooth groups. The probability of a subject having complicated root canal morphology in lateral incisors was significantly higher when the second mesiobuccal canal was present. Clinicians should consider all available information on patients’ root canal morphology when planning new endodontic treatment. Root canal morphology of permanent mandibular lateral incisors showed high association with the root canal morphology of permanent maxillary first molars.

Symmetry of root and root canal morphology of mandibular incisors: A cone-beam computed tomography study in vivo

Background

Aim of this study was to analyze the root canal configuration in mandibular central and lateral incisors in vivo using cone-beam computed tomography (CBCT) imaging.

Material and Methods

A total of 487 mandibular central incisors and 491 mandibular lateral incisors from 250 patients were examined using CBCT imaging, previously taken for diagnosis and treatment. The number of roots, root canal system configuration, presence of apical confluences, distance between confluences and radiographic root end, symmetry between left and right elements were recorded and statistically analyzed.

Results

All the examined teeth presented only one root. No significant differences were found between the prevalence of two root canals in mandibular central incisors (219 teeth, 45%) compared to lateral incisors (211 teeth, 43%).

Conclusions

The percentage of Vertucci type II configuration was higher than expected, being more frequent than type III. Type I was the prevalent, while other configurations were present but rare. Key words:Cone-beam computed tomography, mandibular incisors, root canal anatomy, confluences.

Root canal morphology of permanent teeth in a Malaysian subpopulation using cone-beam computed tomography

Background

To determine the root canal morphology of human permanent maxillary and mandibular teeth in a Malaysian subpopulation using cone-beam computed tomography (CBCT).

Methods

A total of 208 CBCT images were examined retrospectively. Prevalence of an extra root/canal and internal morphology based on Vertucci’s classification were observed in human maxillary and mandibular permanent teeth. Variations in the external and internal morphology were compared in relation to gender and tooth side (left vs right) using Pearson Chi-square and Fisher’s exact tests with significance level set at p < 0.05.

Results

In the maxillary arch, the prevalence of three canals were observed in 0.3% of first premolars and two canals in 46.5% of second premolars. Males displayed significantly higher prevalence of two canals in maxillary second premolars than females (p < 0.05). The prevalence of a second mesiobuccal canal in maxillary first and second molars were 36.3 and 8.5%, respectively. Males displayed significantly higher prevalence of a second mesiobuccal canal in maxillary second molars than females (p < 0.05). The prevalence of a second palatal canal in maxillary first and second molars were 0.9 and 0.6%, respectively. In the mandibular arch, the prevalence of two canals were observed in 5.1% of central incisors, 12.3% of lateral incisors, 6.1% of canines, 18.7% of first premolars and 0.5% of second premolars. The prevalence of a middle mesial canal, second distal canal and extra root (radix entomolaris) were detected in 1.9, 19.5 and 21.4% of mandibular first molars, respectively. The prevalence of a C-shaped canal was observed in 48.7% of mandibular second molars. Females displayed significantly higher prevalence of a C-shaped canal in the right mandibular second molars than males (p < 0.05). No other statistically significant differences in root anatomy and root canal morphology were observed in relation to gender and tooth side.

Conclusions

Wide variations in the root canal morphology exist among Malaysians. CBCT is a clinically useful tool in the identification of external and internal morphological variations in the human teeth.

Second Root Canal in Mandibular Incisors: an Ex Vivo Cone-Beam Computed Tomography (CBCT) Study

Background/Aim: To analyze the internal morphology of mandibular incisors with two root canals using cone-beam computed tomography (CBCT). Material and Methods: 289 (143 central and 146 lateral) extracted intact mandibular incisors were radiographed for detection of a second root canal. The teeth presenting a second root canal were imaged with CBCT and evaluated regarding: root canal type, the distance of the cementoenamel junction (CEJ) to the bifurcation of the canals and the distance of the canal fusion to the apical foramen (in teeth in which canals rejoined). Results: Out of 143 central and 146 lateral mandibular incisors, 41 (28.7%) and 44 (30.1%) teeth respectively showed a second root canal. Types II, III, V and an additional type to Vertucci’s classification were identified. Type III was the most prevalent and presented in 30 (73.2%) central and 34 (77.3%) lateral mandibular incisors with two root canals. The mean values of the distance of the CEJ to the canal bifurcation were 4.2 mm and 4.0 mm for central and lateral mandibular incisors respectively. The mean values of the distance of the canal fusion to the apical foramen 5.5 mm and 5.1 mm for central and lateral mandibular incisors respectively. Conclusions: Mandibular incisors with two root canals mainly present with Vertucci’s Type 3 canal configuration. The canal bifurcation was identified mostly at the coronal and middle thirds of the root, while the canal fusion occurred in the middle third of the root.