Research Article
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Evaluation of root canal morphology molar teeth and distance between additional canals using CBCT

Year 2024, Volume: 4 Issue: 2, 30 - 37, 30.08.2024
https://doi.org/10.61139/ijdor.1517056

Abstract

Background: This study was conducted to analyze the morphological variations of maxillary and mandibular molars in the Turkish population, to evaluate the distances between the additional canals vertically and horizontally, to guide clinicians by determining the distance between the canals.
Materials and Methods: The maxillary and mandibular first and second molars (a total of 50 teeth per group) were using in the study. The teeth were embedded in an arch-shaped silicone impression material. CBCT images of the teeth were recorded. Two examiners scrutinized the root canal systems and sought out any additional canals.
Results: Upper first molars; 16% had three canals, 64% had four canals and 20% had five canals. The average distance between mesiobuccal 1(mb1)-mesiobuccal 2(mb2), mesiobuccal 1(mb1)-mesiobuccal 3(mb3), and distobuccal 1(db1)-distobuccal 2(db2) was 2.35, 2.52 and 1.91 millimeters, respectively.
Upper second molars; 32% had three canals, 52% had four canals and 16% had five canals. The distance between mb1-mb2 and db1-db2 canals was 2.14 and 2.01 mm, respectively. In 16%, the mb2 canal was observed at an average depth of 0.72 mm from mb1. No significant difference was found between the number of canals and additional canals in the upper first molars and upper second molars teeth (p=0,275).
Lower first molars; Two canals were detected in 8%, three canals in 20%, four canals in 28% and five canals in 44%. While 60% of the midmesial canals merged with the mesiolingual canal, 20% merged with the mesiobuccal, and 20% terminated in separate apices. Mesiobuccal(mb)-midmesial and mesiolingual(ml)-midmesial distances were 1.81 and 1.76 mm, respectively.
Lower second molars; 4% had one canal, 8% had two canals, 60% had three canals, 28% had four canals. No midmesal canal was observed in the lower second molars. There was a significant difference between the number of teeth with three canals in the lower first molars and lower second molars teeth (p=0,00).
Conclusions: During root canal treatment, all canal access must be accurately identified. Using adequate light sources, checking the pulp floor with canal probes, strengthening the theoretical knowledge about the points where additional canals can be found can reduce the risk of missed canals.
Strengthening the theoretical knowledge of where additional canals can be found can reduce the risk of missing canals.

Ethical Statement

This study was approved by the local ethics committee of KSU University (2024/06).

Supporting Institution

YOK

Thanks

yok

References

  • 1. Ahmed H, Versiani M, De‐Deus G, Dummer P. A new system for classifying root and root canal morphology. Int Endod J 2017;50(8):761-70.
  • 2. Vizzotto MB, Silveira PF, Arus NA, Montagner F, Gomes BP, da Silveira HE. CBCT for the assessment of second mesiobuccal (MB2) canals in maxillary molar teeth: effect of voxel size and presence of root filling. Int Endod J 2013;46(9):870-6.
  • 3. Tabassum S, Khan FR. Failure of endodontic treatment: The usual suspects. Eur J Dent 2016;10(1):144-7.
  • 4. Mashyakhy M, AlTuwaijri N, Alessa R, Alazzam N, Alotaibi B, Almutairi R, et al. Anatomical evaluation of root and root canal morphology of permanent mandibular dentition among the Saudi Arabian population: a systematic review. BioMed Res Int. 2022;2022(1):2400314.
  • 5. 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(6):391-8.
  • 6. Wu YC, Su CC, Tsai YC, Cheng WC, Chung MP, Chiang HS, et al. Complicated Root Canal Configuration of Mandibular First Premolars Is Correlated with the Presence of the Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in Taiwanese Individuals. J Endod 2017;43(7):1064-71.
  • 7. Nikoloudaki GE, Kontogiannis TG, Kerezoudis NP. Suppl 2: M3: 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. Open Dent J 2015;9:267.
  • 8. Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J 2007;40(10):818-30.
  • 9. Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG. Endodontic applications of cone-beam volumetric tomography. J Endod 2007;33(9):1121-32.
  • 10. Wang Y-L, Chang H-H, Kuo C-I, Chen S-K, Guo M-K, Huang G-F, Lin C-P. A study on the root canal morphology of primary molars by high-resolution computed tomography. J Dent Sci 2013;8(3):321-7.
  • 11. Filpo-Perez C, Bramante CM, Villas-Boas MH, Hungaro Duarte MA, Versiani MA, Ordinola-Zapata R. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar. J Endod. 2015;41(2):231-6.
  • 12. Neelakantan P, Subbarao C, Subbarao CV. Comparative evaluation of modified canal staining and clearing technique, cone-beam computed tomography, peripheral quantitative computed tomography, spiral computed tomography, and plain and contrast medium-enhanced digital radiography in studying root canal morphology. J Endod. 2010;36(9):1547-51.
  • 13. Kim Y, Lee SJ, 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(8):1063-8.
  • 14. Yu X, Guo B, Li KZ, Zhang R, Tian YY, Wang H, D DST. Cone-beam computed tomography study of root and canal morphology of mandibular premolars in a western Chinese population. BMC Med Imag. 2012;12:18.
  • 15. Plotino G, Tocci L, Grande NM, Testarelli L, Messineo D, Ciotti M, et al. Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: a cone-beam computed tomography study in vivo. J Endod. 2013;39(12):1545-8.
  • 16. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984;58(5):589-99.
  • 17. Sert S, Şahinkesen G, Tunca Ym, Aslanalp V, Altinova M. Türk Toplumunda Erkek Alt Ve Üst Çene Sürekli Diş Kanal Şekillerinin Şeffaflaştirma Yöntemi İle Belirlenmesi. Gülhane Tıp Dergisi 2004;46(2):106-114.
  • 18. Betancourt P, Navarro P, Munoz G, Fuentes R. Prevalence and location of the secondary mesiobuccal canal in 1,100 maxillary molars using cone beam computed tomography. BMC Med Imaging 2016;16(1):66.
  • 19. Betancourt P, Navarro P, Cantín M, Fuentes R. Cone-beam computed tomography study of prevalence and location of MB2 canal in the mesiobuccal root of the maxillary second molar. Int J Clin Med. 2015;8(6):9128.
  • 20. Betancourt P, Fuentes R, Aracena Rojas S, Cantín M, Navarro Cáceres P. Prevalencia del segundo canal en la raíz mesiovestibular de los primeros molares maxilares mediante tomografía computarizada de haz de cono. Av Odontoestomatol. 2013;29(1):31-6.
  • 21. Zheng QH, Wang Y, Zhou XD, Wang Q, Zheng GN, Huang DM. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. J Endod. 2010;36(9):1480-4.
  • 22. Qiao X, Xu T, Chen L, Yang D. Analysis of root canal curvature and root canal morphology of maxillary posterior teeth in Guizhou, China. Med Sci Monit.2021;27:e928758-1.
  • 23. Lee JH, Kim KD, Lee JK, Park W, Jeong JS, Lee Y, et al. Mesiobuccal root canal anatomy of Korean maxillary first and second molars by cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111(6):785-91.
  • 24. Betancourt P, Navarro P, Cantin M, Fuentes R. Cone-beam computed tomography study of prevalence and location of MB2 canal in the mesiobuccal root of the maxillary second molar. Int J Clin Exp Med. 2015;8(6):9128-34.
  • 25. Silva EJNL, Nejaim Y, Silva AI, Haiter-Neto F, Zaia AA, Cohenca N. Evaluation of root canal configuration of maxillary molars in a Brazilian population using cone-beam computed tomographic imaging: an in vivo study. J Endod. 2014;40(2):173-6.
  • 26. Yang L, Han J, Wang Q, Wang Z, Yu X, Du Y. Variations of root and canal morphology of mandibular second molars in Chinese individuals: a cone-beam computed tomography study. BMC oral health. 2022;22(1):274.
  • 27. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984;58(5):589-99.
  • 28. Peeters HH, Suardita K, Setijanto D. Prevalence of a second canal in the mesiobuccal root of permanent maxillary first molars from an Indonesian population. J Oral Sci. 2011;53(4):489-94.
  • 29. Görduysus MÖ, Görduysus M, Friedman S. Operating microscope improves negotiation of second mesiobuccal canals in maxillary molars. J Endod. 2001;27(11):683-6.
  • 30. Tuncer AK, Haznedaroglu F, Sert S. The location and accessibility of the second mesiobuccal canal in maxillary first molar. Eur J Dent. 2010;4(1):12.
  • 31. Degerness R, Bowles W. Anatomic determination of the mesiobuccal root resection level in maxillary molars. J Endod. 2008;34(10):1182-6.
  • 32. Caliskan MK, Pehlivan Y, Sepetcioglu F, Turkun M, Tuncer SS. Root canal morphology of human permanent teeth in a Turkish population. J Endod. 1995;21(4):200-4.

AZI DİŞLERİNDE KÖK KANAL MORFOLOJİSİNİN VE EK KANALLAR ARASINDAKİ MESAFELERİN CBCT KULLANILARAK DEĞERLENDİRİLMESİ

Year 2024, Volume: 4 Issue: 2, 30 - 37, 30.08.2024
https://doi.org/10.61139/ijdor.1517056

Abstract

Amaç: Bu çalışma, Türk toplumunda üst ve alt büyük azı dişlerinin morfolojik varyasyonlarını analiz etmek, ekstra kanallar arasındaki mesafeleri dikey ve yatay olarak değerlendirmek, kanallar arasındaki mesafeyi belirleyerek klinisyenlere yol göstermek amacıyla yapılmıştır.
Materyal ve Metod: Çalışmada üst ve alt birinci ve ikinci büyük azı dişleri (grup başına toplam 50 diş) kullanılmıştır. Dişler ark şeklindeki silikon ölçü malzemesinin içine gömülmüştür. Dişlerin CBCT görüntüleri kaydedilmiştir. İki araştırmacı kök kanal sistemlerini inceleyerek ek kanal olup olmadığını araştırmıştır.
Bulgular: Üst birinci azı dişleri; %16'sında üç kanal, %64'ünde dört kanal ve %20'sinde beş kanal vardı. Meziobukkal 1(mb1)- meziobukkal 2(mb2), meziobukkal 1(mb1)-meziobukkal 3(mb3) ve distobukkal1(db1)-distobukkal 2(db2) arasındaki ortalama mesafe sırasıyla 2,35, 2,52 ve 1,91 milimetreydi (mm).
Üst ikinci azı dişleri; %32'sinde üç kanal, %52'sinde dört kanal ve %16'sında beş kanal vardı. Mb1-mb2 ve db1-db2 kanalları arasındaki mesafe sırasıyla 2,14 ve 2,01 mm idi. %16'sında mb2 kanalı mb1'den ortalama 0,72 mm derinlikte gözlendi. Üst birinci azı ve üst ikinci azı dişlerinde kanal sayısı ve ek kanal sayıları arasında anlamlı fark bulunamadı (p=0,275).
Alt birinci azı dişleri; %8'inde iki kanal, %20'sinde üç kanal, %28'inde dört kanal ve %44'ünde beş kanal tespit edildi. Midmesial kanalların %60'ı meziolingual(ml) kanalla, %20'si mezio-bukkal(mb) kanalla birleşirken %20'si ayrı apekslerde sonlandı. Mb-midmesial ve ml-midmesial mesafeleri sırasıyla 1,81 ve 1,76 mm idi.
Alt ikinci azı dişleri; %4'ünde bir kanal, %8'inde iki kanal, %60'ında üç kanal, %28'inde dört kanal vardı. Alt ikinci büyük azı dişlerinde midmesial kanal görülmedi. Alt birinci azı ve alt ikinci azı dişlerinde üç kanallı diş sayıları arasında anlamlı fark vardı (p=0,00).
Sonuç: Kanal tedavisi sırasında tüm kanal girişlerinin doğru bir şekilde belirlenmesi gerekmektedir. Yeterli ışık kaynaklarının kullanılması, kanal sondları ile pulpa tabanının kontrol edilmesi, ekstra kanalların bulunabileceği noktalar hakkındaki teorik bilginin güçlendirilmesi kanalların gözden kaçma riskini azaltabilir.

References

  • 1. Ahmed H, Versiani M, De‐Deus G, Dummer P. A new system for classifying root and root canal morphology. Int Endod J 2017;50(8):761-70.
  • 2. Vizzotto MB, Silveira PF, Arus NA, Montagner F, Gomes BP, da Silveira HE. CBCT for the assessment of second mesiobuccal (MB2) canals in maxillary molar teeth: effect of voxel size and presence of root filling. Int Endod J 2013;46(9):870-6.
  • 3. Tabassum S, Khan FR. Failure of endodontic treatment: The usual suspects. Eur J Dent 2016;10(1):144-7.
  • 4. Mashyakhy M, AlTuwaijri N, Alessa R, Alazzam N, Alotaibi B, Almutairi R, et al. Anatomical evaluation of root and root canal morphology of permanent mandibular dentition among the Saudi Arabian population: a systematic review. BioMed Res Int. 2022;2022(1):2400314.
  • 5. 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(6):391-8.
  • 6. Wu YC, Su CC, Tsai YC, Cheng WC, Chung MP, Chiang HS, et al. Complicated Root Canal Configuration of Mandibular First Premolars Is Correlated with the Presence of the Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in Taiwanese Individuals. J Endod 2017;43(7):1064-71.
  • 7. Nikoloudaki GE, Kontogiannis TG, Kerezoudis NP. Suppl 2: M3: 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. Open Dent J 2015;9:267.
  • 8. Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J 2007;40(10):818-30.
  • 9. Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG. Endodontic applications of cone-beam volumetric tomography. J Endod 2007;33(9):1121-32.
  • 10. Wang Y-L, Chang H-H, Kuo C-I, Chen S-K, Guo M-K, Huang G-F, Lin C-P. A study on the root canal morphology of primary molars by high-resolution computed tomography. J Dent Sci 2013;8(3):321-7.
  • 11. Filpo-Perez C, Bramante CM, Villas-Boas MH, Hungaro Duarte MA, Versiani MA, Ordinola-Zapata R. Micro-computed tomographic analysis of the root canal morphology of the distal root of mandibular first molar. J Endod. 2015;41(2):231-6.
  • 12. Neelakantan P, Subbarao C, Subbarao CV. Comparative evaluation of modified canal staining and clearing technique, cone-beam computed tomography, peripheral quantitative computed tomography, spiral computed tomography, and plain and contrast medium-enhanced digital radiography in studying root canal morphology. J Endod. 2010;36(9):1547-51.
  • 13. Kim Y, Lee SJ, 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(8):1063-8.
  • 14. Yu X, Guo B, Li KZ, Zhang R, Tian YY, Wang H, D DST. Cone-beam computed tomography study of root and canal morphology of mandibular premolars in a western Chinese population. BMC Med Imag. 2012;12:18.
  • 15. Plotino G, Tocci L, Grande NM, Testarelli L, Messineo D, Ciotti M, et al. Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: a cone-beam computed tomography study in vivo. J Endod. 2013;39(12):1545-8.
  • 16. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984;58(5):589-99.
  • 17. Sert S, Şahinkesen G, Tunca Ym, Aslanalp V, Altinova M. Türk Toplumunda Erkek Alt Ve Üst Çene Sürekli Diş Kanal Şekillerinin Şeffaflaştirma Yöntemi İle Belirlenmesi. Gülhane Tıp Dergisi 2004;46(2):106-114.
  • 18. Betancourt P, Navarro P, Munoz G, Fuentes R. Prevalence and location of the secondary mesiobuccal canal in 1,100 maxillary molars using cone beam computed tomography. BMC Med Imaging 2016;16(1):66.
  • 19. Betancourt P, Navarro P, Cantín M, Fuentes R. Cone-beam computed tomography study of prevalence and location of MB2 canal in the mesiobuccal root of the maxillary second molar. Int J Clin Med. 2015;8(6):9128.
  • 20. Betancourt P, Fuentes R, Aracena Rojas S, Cantín M, Navarro Cáceres P. Prevalencia del segundo canal en la raíz mesiovestibular de los primeros molares maxilares mediante tomografía computarizada de haz de cono. Av Odontoestomatol. 2013;29(1):31-6.
  • 21. Zheng QH, Wang Y, Zhou XD, Wang Q, Zheng GN, Huang DM. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. J Endod. 2010;36(9):1480-4.
  • 22. Qiao X, Xu T, Chen L, Yang D. Analysis of root canal curvature and root canal morphology of maxillary posterior teeth in Guizhou, China. Med Sci Monit.2021;27:e928758-1.
  • 23. Lee JH, Kim KD, Lee JK, Park W, Jeong JS, Lee Y, et al. Mesiobuccal root canal anatomy of Korean maxillary first and second molars by cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011;111(6):785-91.
  • 24. Betancourt P, Navarro P, Cantin M, Fuentes R. Cone-beam computed tomography study of prevalence and location of MB2 canal in the mesiobuccal root of the maxillary second molar. Int J Clin Exp Med. 2015;8(6):9128-34.
  • 25. Silva EJNL, Nejaim Y, Silva AI, Haiter-Neto F, Zaia AA, Cohenca N. Evaluation of root canal configuration of maxillary molars in a Brazilian population using cone-beam computed tomographic imaging: an in vivo study. J Endod. 2014;40(2):173-6.
  • 26. Yang L, Han J, Wang Q, Wang Z, Yu X, Du Y. Variations of root and canal morphology of mandibular second molars in Chinese individuals: a cone-beam computed tomography study. BMC oral health. 2022;22(1):274.
  • 27. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984;58(5):589-99.
  • 28. Peeters HH, Suardita K, Setijanto D. Prevalence of a second canal in the mesiobuccal root of permanent maxillary first molars from an Indonesian population. J Oral Sci. 2011;53(4):489-94.
  • 29. Görduysus MÖ, Görduysus M, Friedman S. Operating microscope improves negotiation of second mesiobuccal canals in maxillary molars. J Endod. 2001;27(11):683-6.
  • 30. Tuncer AK, Haznedaroglu F, Sert S. The location and accessibility of the second mesiobuccal canal in maxillary first molar. Eur J Dent. 2010;4(1):12.
  • 31. Degerness R, Bowles W. Anatomic determination of the mesiobuccal root resection level in maxillary molars. J Endod. 2008;34(10):1182-6.
  • 32. Caliskan MK, Pehlivan Y, Sepetcioglu F, Turkun M, Tuncer SS. Root canal morphology of human permanent teeth in a Turkish population. J Endod. 1995;21(4):200-4.
There are 32 citations in total.

Details

Primary Language English
Subjects Endodontics
Journal Section Research Articles
Authors

Esra Balkanlıoğlu 0009-0009-0903-7129

Zeynelabidin Şimşekyılmaz 0000-0003-1317-0765

Publication Date August 30, 2024
Submission Date July 16, 2024
Acceptance Date August 5, 2024
Published in Issue Year 2024 Volume: 4 Issue: 2

Cite

APA Balkanlıoğlu, E., & Şimşekyılmaz, Z. (2024). Evaluation of root canal morphology molar teeth and distance between additional canals using CBCT. HRU International Journal of Dentistry and Oral Research, 4(2), 30-37. https://doi.org/10.61139/ijdor.1517056
AMA Balkanlıoğlu E, Şimşekyılmaz Z. Evaluation of root canal morphology molar teeth and distance between additional canals using CBCT. HRU Int J Dent Oral Res. August 2024;4(2):30-37. doi:10.61139/ijdor.1517056
Chicago Balkanlıoğlu, Esra, and Zeynelabidin Şimşekyılmaz. “Evaluation of Root Canal Morphology Molar Teeth and Distance Between Additional Canals Using CBCT”. HRU International Journal of Dentistry and Oral Research 4, no. 2 (August 2024): 30-37. https://doi.org/10.61139/ijdor.1517056.
EndNote Balkanlıoğlu E, Şimşekyılmaz Z (August 1, 2024) Evaluation of root canal morphology molar teeth and distance between additional canals using CBCT. HRU International Journal of Dentistry and Oral Research 4 2 30–37.
IEEE E. Balkanlıoğlu and Z. Şimşekyılmaz, “Evaluation of root canal morphology molar teeth and distance between additional canals using CBCT”, HRU Int J Dent Oral Res, vol. 4, no. 2, pp. 30–37, 2024, doi: 10.61139/ijdor.1517056.
ISNAD Balkanlıoğlu, Esra - Şimşekyılmaz, Zeynelabidin. “Evaluation of Root Canal Morphology Molar Teeth and Distance Between Additional Canals Using CBCT”. HRU International Journal of Dentistry and Oral Research 4/2 (August 2024), 30-37. https://doi.org/10.61139/ijdor.1517056.
JAMA Balkanlıoğlu E, Şimşekyılmaz Z. Evaluation of root canal morphology molar teeth and distance between additional canals using CBCT. HRU Int J Dent Oral Res. 2024;4:30–37.
MLA Balkanlıoğlu, Esra and Zeynelabidin Şimşekyılmaz. “Evaluation of Root Canal Morphology Molar Teeth and Distance Between Additional Canals Using CBCT”. HRU International Journal of Dentistry and Oral Research, vol. 4, no. 2, 2024, pp. 30-37, doi:10.61139/ijdor.1517056.
Vancouver Balkanlıoğlu E, Şimşekyılmaz Z. Evaluation of root canal morphology molar teeth and distance between additional canals using CBCT. HRU Int J Dent Oral Res. 2024;4(2):30-7.