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

Yıl 2024, Cilt: 4 Sayı: 2, 30 - 37, 30.08.2024

Esra Balkanlıoğlu , Zeynelabidin Şimşekyılmaz

https://doi.org/10.61139/ijdor.1517056

Öz

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.

Anahtar Kelimeler

Midmesial Canal, Root Morphology, Second Mesiobuccal Canal, Cbct, Additional Canal

Etik Beyan

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

Destekleyen Kurum

YOK

Teşekkür

yok

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

Öz

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.

Anahtar Kelimeler

Midmesial Kanal, kök morfolojisi, Cbct, İkinci meziobukkal kanal, Ek kanal

Kaynakça

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