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

Retrospective study of the morphology of third maxillary molars among the population of Lower Silesia based on analysis of cone beam computed tomography

INTRODUCTION

Understanding the anatomy of root canal systems and being aware of their variations is crucial for successful endodontic treatment. Specifically, the intricate and diverse nature of the root anatomy in maxillary third molars poses a significant challenge for dental clinicians. The study analyzed the morphology of the root canal system in maxillary third molars among residents of the Lower Silesia region in Poland using cone beam computed tomography (CBCT).

MATERIAL AND METHODS

This retrospective cross-sectional imaging study was conducted at the X-Ray Diagnostics Laboratory of the Academic Dental Polyclinic of Wroclaw Medical University, Poland. The study evaluated 316 CBCT scans and included 196 maxillary third molars. They were obtained from 118 females and 78 males over the age of 18, in the period from January to April 2022 (three consecutive months). The number of roots, root canals, and root canal configurations according to Vertucci's classification were analyzed.

RESULTS

Three-rooted maxillary molars were found most often (64.29%), followed by single-rooted (24.49%), two-rooted (7.65%), and four-rooted (3.57%) teeth. Among all the roots examined, Vertucci Type I root canals were the most prevalent. Our research found that single-rooted forms (40 teeth, 33.89% vs. 8 teeth, 10.26%, p = 0.0013) of maxillary third molars were significantly more common in females than in males. However, three-rooted forms (62 teeth, 79.49% vs. 64 teeth, 54.24%, p = 0.0013) of maxillary third molars were significantly more common in males than in females.

DISCUSSION

In the Lower Silesia region, the typical maxillary third molar in the Polish population has a three-rooted structure with Vertucci Type I root canal configuration. We noted a sex-dependent correlation in maxillary third molar morphology, with single-rooted forms more prevalent in women and three-rooted forms in men.

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.

Root and root canal variations of the human maxillary and mandibular third molars in a Chinese population: A micro-computed tomographic study

OBJECTIVES

To investigate the anatomical variations of the root and root canal configuration of the human third molars.

DESIGNS

A total of 130 maxillary and 130 mandibular third molars were collected from a native Chinese population. All teeth were scanned by micro-computed tomography. After 3D reconstruction, the root and canal morphology of each tooth was examined both qualitatively and quantitatively.

RESULTS

For maxillary molars, a single fused root (67 cases, 51.5%) and a single root canal system (64 cases, 49.2%) was most common root/canal form; the typical three-rooted molars were detected only in 33 cases (25.4%), and the secondary MB canals were detected only in 9 molars (6.9%). For mandibular molars, 62 teeth were single-rooted (47.7%) and 42 had a single root canal system (32.3%); 20 singled-rooted and 60 double-rooted molars exhibited independent mesial and distal root canal systems (61.5%), and the type 1-1 canal was the most common configuration for mesial (57 cases) and distal (81 cases) root canal systems. C-shaped canals were detected in 11 maxillary and 36 mandibular single-rooted molars. The mean root surface area, root and crown volume of mandibular third molars were significantly higher than the maxillary third molars (P <  0.01).

CONCLUSION

The root canal system of the third molars may exhibit several anatomic variations. Whereas in most of cases, the degree of the canal differentiation was at a low level, and the canal form was not complicate.

Computed tomography: Will the slices reveal the truth

With the advances in the field of imaging sciences, new methods have been developed in dental radiology. These include digital radiography, density analyzing methods, cone beam computed tomography (CBCT), magnetic resonance imaging, ultrasound, and nuclear imaging techniques, which provide high-resolution detailed images of oral structures. The current review aims to critically elaborate the use of CBCT in endodontics.