Evaluation of Root Canal Configuration of Permanent Maxillary Molar Teeth in a Turkish Subpopulation: A Cone-Beam Computed Tomographic Study

Yıl 2023, , 89 - 95, 05.03.2023

Erhan Erkan , Keziban Olcay , Tan Fırat Eyüboğlu , Elif Şener , Mustafa Gündoğar

https://doi.org/10.26453/otjhs.1170873

Öz

Objective: Maxillary molars may be challenging for root canal treatment due to their complex canal anatomy and additional root canals, especially in the mesiobuccal root. The current study aimed to investigate the prevalence of root and root canal numbers of maxillary molar in a selected Turkish population.
Materials and Methods: A total of 905 first and second maxillary molars were evaluated using cone-beam computed tomography (CBCT) images. The number of roots and canals was recorded and the mesiobuccal canal was further evaluated with the Vertucci classification.
Results: A total of 394 teeth had a second mesiobuccal (MB2) canal (43.5%). While 90.4% of all maxillary molars had three roots, 44% had four root canals. The most common root canal anatomy of mesiobuccal root canals was Type II (42.6%) followed by Type IV (31.5%) and Type III (22.1%).
Conclusions: It is clear that the second mesial root canal in permanent maxillary molars should be carefully searched for the long-term success of root canal treatments. It is seen that CBCT sections will be beneficial in diagnosis and treatment in better understanding the anatomical structure of the teeth and determining possible anatomical deviations.

Anahtar Kelimeler

Cone-beam CT, root canal morphology, maxillary molar

Bir Türk Alt Popülasyonunda Kalıcı Üst Azı Dişlerinin Kök Kanal Konfigürasyonunun Değerlendirilmesi: Konik Işınlı Bilgisayarlı Tomografi Çalışması

Öz

Amaç: Üst çene azı dişleri, karmaşık kök kanal anatomisi ve özellikle mezial kökteki ek kök kanal sayıları nedeniyle endodontik tedaviyi zorlaştırabilir. Bu nedenle başarılı bir kanal tedavisi için üst çene azı dişlerinin anatomik özelliklerinin analiz edilmesi gerekmektedir. Bu çalışmanın amacı, seçilmiş bir Türk nüfusunda üst çene azı dişlerinin kök ve kök kanal sayılarının prevalansını araştırmaktır.
Materyal ve Metot: Konik ışınlı bilgisayarlı tomografi (KIBT) kullanılarak toplam 905 birinci ve ikinci kalıcı üst azı dişi değerlendirildi. Kök ve kök kanal sayıları kaydedilerek mezyobukkal meziobukkal kök kanalı Vertucci sınıflamasına göre değerlendirildi.
Bulgular: Toplam 394 üst azıda ikinci bir mezial (MB2) kök kanalı (% 43,5) vardı. Tüm üst büyük azı dişlerinin %90,4' ünde üç adet kök varken, %44'ünde ise 4 kök kanalı vardı. Mezial kök kanallarının en yaygın kök kanal anatomisi Tip II (% 42,6) iken, bunu Tip IV (% 31,5) ve Tip III (% 22,1) takip etti.
Sonuç: Üst daimi azı dişlerindeki ikinci mezial kök kanalının, kanal tedavilerinin uzun dönem başarısı için dikkatlice aranmasında büyük fayda olduğu açıktır. Dişlerinin anatomik yapısının daha iyi anlaşılmasında ve olası anatomik sapmaların belirlenmesinde KIBT kesitlerinin teşhis ve tedaviye oldukça yardımcı olacağı görülmektedir.

Anahtar Kelimeler

Konik ışınlı BT, kök kanal morfolojisi, üst azı dişi

Kaynakça

• 1. Hartwell G, Appelstein CM, Lyons WW, Guzek ME. The incidence of four canals in maxillary first molars: a clinical determination. J Am Dent Assoc. 2007;138(10):1344-6. doi:0.14219/jada.archive.2007.0050
• 2. Smadi L, Khraisat A. Detection of a second mesiobuccal canal in the mesiobuccal roots of maxillary first molar teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(3):77-81. doi:10.1016/j.tripleo.2006.10.007
• 3. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984;58(5):589-99. doi:10.1016/0030-4220(84)90085-9
• 4. Weine FS, Healey HJ, Gerstein H, Evanson L. Canal configuration in the mesiobuccal root of the maxillary first molar and its endodontic significance. J Endod. 2012;38(10):1305-8. doi:10.1016/j.joen.2012.08.005
• 5. 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(2):162–9. doi:10.1111/j.1365-2591.2010.01826.x
• 6. Zhang Y, Xu H, Wang D, et al. Assessment of the Second Mesiobuccal Root Canal in Maxillary First Molars: A Cone-beam Computed Tomographic Study. J Endod. 2017;43(12):1990-1996. doi:10.1016/j.joen.2017.06.021
• 7. 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. doi:10.1016/j.joen.2010.06.018
• 8. 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. doi:10.1016/j.joen.2010.05.008
• 9. Badole GP, Bahadure RN, Warhadpande MM, Kubde R. A rare root canal configuration of maxillary second molar: a case report. Case Rep Dent. 2012;2012:767582. doi:10.1155/2012/767582
• 10. Schryvers A, Govaerts D, Politis C, Lambrechts P. Endodontic management of a maxillary first molar with two palatal roots: A case report. Aust Endod J. 2019;45(3):420-425. doi:10.1111/aej.12320
• 11. Yilmaz Z, Tuncel B, Serper A, Calt S. C-shaped root canal in a maxillary first molar: a case report. Int Endod J. 2006;39(2):162–6. doi:10.1111/j.1365-2591.2006.01069.x
• 12. Ng YL, Aung TH, Alavi A, Gulabivala K. Root and canal morphology of Burmese maxillary molars. Int Endod J. 2001;34(8):620–30. doi:10.1046/j.1365-2591.2001.00438.x
• 13. Calişkan MK, Pehlivan Y, Sepetçioğlu F, Türkün M, Tuncer SS. Root canal morphology of human permanent teeth in a Turkish population. J Endod. 1995;21(4):200-4. doi:10.1016/S0099-2399(06)80566-2
• 14. 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. doi:10.1097/00004770-200406000-00004
• 15. Special Committee to Revise the Joint AAE/AAOMR Position Statement on use of CBCT in Endodontics. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(4):508-12. doi:10.1016/j.oooo.2015.07.033
• 16. Martins JNR, Alkhawas MAM, Altaki Z, et al. Worldwide Analyses of Maxillary First Molar Second Mesiobuccal Prevalence: A Multicenter Cone-beam Computed Tomographic Study. J Endod. 2018;44(11):1641-1649. doi:10.1016/j.joen.2018.07.027
• 17. Tian XM, Yang XW, Qian L, Wei B, Gong Y. Analysis of the Root and Canal Morphologies in Maxillary First and Second Molars in a Chinese Population Using Cone-beam Computed Tomography. J Endod. 2016;42(5):696-701. doi:10.1016/j.joen.2016.01.017
• 18. Razumova S, Brago A, Khaskhanova L, Barakat H, Howijieh A. Evaluation of Anatomy and Root Canal Morphology of the Maxillary First Molar Using the Cone-Beam Computed Tomography among Residents of the Moscow Region. Contemp Clin Dent. 2018;133-136. doi:10.4103/ccd.ccd_127_18
• 19. Candeiro GTM, Gonçalves SDS, Lopes LLA, et al. Internal configuration of maxillary molars in a subpopulation of Brazil's Northeast region: A CBCT analysis. Braz Oral Res. 2019;26;33:e082.doi:10.1590/1807-3107bor-2019.vol33.0082
• 20. Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod. 2006;32(9):813-21. doi:10.1016/j.joen.2006.04.014
• 21. Khademi A, Zamani Naser A, Bahreinian Z, Mehdizadeh M, Najarian M, Khazaei S. Root Morphology and Canal Configuration of First and Second Maxillary Molars in a Selected Iranian Population: A Cone-Beam Computed Tomography Evaluation. Iran Endod J. 2017;12(3):288-292. doi:10.22037/iej.v12i3.13708
• 22. 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. doi:10.1016/j.joen.2012.04.025
• 23. 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(10):1622-7. doi:10.1016/j.joen.2010.07.006
• 24. Pérez-Heredia M, Ferrer-Luque CM, Bravo M, Castelo-Baz P, Ruíz-Piñón M, Baca P. Cone-beam Computed Tomographic Study of Root Anatomy and Canal Configuration of Molars in a Spanish Population. J Endod. 2017;43(9):1511-1516. doi:10.1016/j.joen.2017.03.026
• 25. Aydin H. Analysis of root and canal morphology of fused and separate rooted maxillary molar teeth in Turkish population. Niger J Clin Pract. 2021;24(3):435-442. doi:10.4103/njcp.njcp_316_20
• 26. Barbhai S, Shetty R, Joshi P, and et al. Evaluation of Root Anatomy and Canal Configuration of Human Permanent Maxillary First Molar Using Cone-Beam Computed Tomography: A Systematic Review. Int J Environ Res Public Health. 2022;16;19(16):10160. doi: 10.3390/ijerph191610160
• 27. Martins JNR, Marques D, Silva EJNL, Caramês J, Versiani MA. Prevalence Studies on Root Canal Anatomy Using Cone-beam Computed Tomographic Imaging: A Systematic Review. J Endod. 2019;45(4):372-386. doi:10.1016/j.joen.2018.12.016
• 28. al Shalabi RM, Omer OE, Glennon J, Jennings M, Claffey NM. Root canal anatomy of maxillary first and second permanent molars. Int Endod J. 2000;33(5):405-14. doi:10.1046/j.1365-2591.2000.00221.x