Evaluation of C-shaped canal configuration in maxillary molars: A retrospective cone-beam computed tomography study

Year 2021, Volume: 11 Issue: 3, 444 - 448, 27.09.2021

Emre Köse , Rüya Ak

https://doi.org/10.33808/clinexphealthsci.785232

Cited By: 1

Abstract

Objective: The aim of this retrospective study was to evaluate the prevalence of C-shaped canal configuration in maxillary first and second molars according to sex and gender by using CBCT in a Turkish population.
Methods: In this retrospective study, 709 first and 739 second maxillary molars were examined. CBCT images of teeth were examined in different axial sections to determine the presence of C-shaped canal configuration. C-shaped canal configuration was classified into five groups according to the fusion of root canals. Prevalence of C-shaped canal configuration between first and second molars, age groups and genders were compared.
Results: Total of 1448 teeth were evaluated and 3% (43) of them had C-shaped canal configuration. The presence of C-shaped canal configuration was significantly more common in the second molars than the first molars (p = 0.000) No significant difference in the prevalence of C-shaped configuration was observed comparing genders and age groups (p>0.05). Type A and E canal configuration were not detected in first molars.
Conclusion: C-shaped canal configuration is a rare anatomical variation of maxillary molars.
This variation includes fins or isthmuses connecting root canals which create challenges during endodontic treatment. Perceiving the variations with CBCT imaging helps clinicians to understand and treat complex cases without complication. Clinicians should be knowledgeable about the rare variations for better outcomes.

Keywords

canal configuration, cbct, c-shaped, maxillary molar

References

• 1. Jo H-H, Min J-B, Hwang H-K. Analysis of C-shaped root canal configuration in maxillary molars in a Korean population using cone-beam computed tomography. Restor Dent Endod 2016;41:55-62.
• 2. Kottoor J, Velmurugan N, Ballal S, Roy A. Four-rooted maxillary first molar having C-shaped palatal root canal morphology evaluated using cone-beam computerized tomography: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:e41-e5.
• 3. Singla M, Aggarwal V. C-shaped palatal canal in maxillary second molar mimicking two palatal canals diagnosed with the aid of spiral computerized tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e92-e5.
• 4. Bulut DG, Kose E, Ozcan G, Sekerci AE, Canger EM, Sisman Y. Evaluation of root morphology and root canal configuration of premolars in the Turkish individuals using cone beam computed tomography. Eur. J. Dent. 2015;9:551.
• 5. Martins JN, Mata A, Marques D, Anderson C, Caramês J. Prevalence and characteristics of the maxillary C-shaped molar. J Endod 2016;42:383-9.
• 6. Ordinola‐Zapata R, Martins J, Bramante CM, Villas‐Boas M, Duarte M, Versiani M. Morphological evaluation of maxillary second molars with fused roots: a micro‐CT study. Int. Endod. J. 2017;50:1192-200.
• 7. Martins JN, Quaresma S, Quaresma MC, Frisbie-Teel J. C-shaped maxillary permanent first molar: a case report and literature review. J Endod. 2013;39:1649-53.
• 8. Cooke HG, Cox FL. C-shaped canal configurations in mandibular molars. The Journal of the American Dental Association. 1979;99:836-9.
• 9. Lopes DS, Câmara AC, Aguiar CM, Do Nascimento MDCC, De Araujo LF. A C-Shaped Canal in a Maxillary Second Molar: Prexion 3D Cone-Beam Computed Tomography Analysis. Acta Stomatol. Croat. 2016;50:354.
• 10. Reddy YP, Karpagavinayagam K, Subbarao C. Management of dens invaginatus diagnosed by spiral computed tomography: a case report. J Endod 2008;34:1138-42.
• 11. Patel S, Durack C, Abella F, Roig M, Shemesh H, Lambrechts P, et al. European Society of Endodontology position statement: the use of CBCT in endodontics. Int. Endod. J. 2014;47:502-4.
• 12. Neelakantan P, Subbarao C, Ahuja R, Subbarao CV. Root and canal morphology of Indian maxillary premolars by a modified root canal staining technique. Odontology. 2011;99:18-21.
• 13. Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod. 2004;30:391-8.
• 14. Weng X-L, Yu S-B, Zhao S-L, Wang H-G, Mu T, Tang R-Y, et al. Root canal morphology of permanent maxillary teeth in the Han nationality in Chinese Guanzhong area: a new modified root canal staining technique. J Endod 2009;35:651-6.
• 15. Lambrianidis T, Lyroudia K, Pandelidou O, Nicolaou A. Evaluation of periapical radiographs in the recognition of C‐shaped mandibular second molars. Int. Endod. J. 2001;34:458-62.
• 16. Fan B, Cheung GS, Fan M, Gutmann JL, Bian Z. C-shaped canal system in mandibular second molars: part I—anatomical features. J Endod. 2004;30:899-903.
• 17. De Moor R. C‐shaped root canal configuration in maxillary first molars. Int. Endod. J. 2002;35:200-8.
• 18. Ross IF, Evanchik PA. Root fusion in molars: incidence and sex linkage. J. Periodontol. 1981;52:663-7.
• 19. Trope M, Elfenbein L, Tronstad L. Mandibular premolars with more than one root canal in different race groups. J Endod. 1986;12:343-5.
• 20. Yang ZP, Yang SF, Lee G. The root and root canal anatomy of maxillary molars in a Chinese population. DENT TRAUMATOL. 1988;4:215-8.
• 21. Newton CW, McDonald S. A C-shaped canal configuration in a maxillary first molar. J Endod. 1984;10:397-9.
• 22. Helvacioglu-Yigit D, Sinanoglu A. Use of cone-beam computed tomography to evaluate C-shaped root canal systems in mandibular second molars in a Turkish subpopulation: a retrospective study. Int Endod J. 2013;46:1032-8.
• 23. Pawar AM, Pawar M, Kfir A, Singh S, Salve P, Thakur B, et al. Root canal morphology and variations in mandibular second molar teeth of an Indian population: an in vivo cone-beam computed tomography analysis. Clin. Oral Investig. 2017;21:2801-9.
• 24. Manning S. Root canal anatomy of mandibular second molars: Part II C‐shaped canals. Int. Endod. J. 1990;23:40-5.
• 25. Zheng Q-h, Wang Y, Zhou X-d, Wang Q, Zheng G-n, Huang D-m. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. J Endod. 2010;3:1480-4.
• 26. Neelakantan P, Subbarao C, Ahuja R, Subbarao CV, Gutmann JL. Cone-beam computed tomography study of root and canal morphology of maxillary first and second molars in an Indian population. J Endod. 2010;36:1622-7.
• 27. Zhang R, Yang H, Yu X, Wang H, Hu T, Dummer PMH. Use of CBCT to identify the morphology of maxillary permanent molar teeth in a Chinese subpopulation. Int. Endod. J. 2011;44:162-9.
• 28. Kim Y, Lee S-J, Woo J. Morphology of maxillary first and second molars analyzed by cone-beam computed tomography in a Korean population: variations in the number of roots and canals and the incidence of fusion. J Endod. 2012;38:1063-8.
• 29. Lascala C, Panella J, Marques MM. Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT-NewTom). DENTOMAXILLOFAC RAD. 2004;33:291-4.
• 30. Cassetta M, Stefanelli LV, Pacifici A, Pacifici L, Barbato E. How accurate Is CBCT in measuring bone density? A comparative CBCT‐CT in vitro study. CLIN IMPLANT DENT R. 2014;16:471-8.
• 31. Horner K. Radiation protection: cone beam CT for dental and maxillofacial radiology provisional guidelines 2009. SedentextCT; 2009.