A microcomputed tomographic analysis of the morphological variabilities and incidence of extra canals in mandibular first molar teeth in an Egyptian subpopulation

Abstract

A well-protected microbial habitat may be present in the root and canal morphology, which is varied and complicated. Before initiating effective root canal treatment, a detailed knowledge of the root and canal anatomical variances in each tooth is a must. This study aimed to investigate the root canal configuration, apical constriction anatomy, location of the apical foramen, dentine thickness, and prevalence of accessory canals in mandibular molar teeth in an Egyptian subpopulation using micro-computed tomography (microCT). A total of 96 mandibular first molars were scanned using microCT, and 3D reconstruction was performed using Mimics software. The root canal configurations of each of the mesial and distal root were classified with two different classification systems. The prevalence and dentin thickness around middle mesial and middle distal canals were investigated. The number, location and anatomy of major apical foramina and the apical constriction anatomy analysed. The number and location of accessory canals were identified. Our findings showed that two separate canals (15%) and one single canal (65%) were the most common configuration in the mesial and distal roots, respectively. More than half of the mesial roots had complex canal configurations and 51% had middle mesial canals. The single apical constriction anatomy was the most common for both canals followed by the parallel anatomy. Disto-lingual and distal locations of the apical foramen are the most common location for both roots. Mandibular molars in Egyptians show a wide range of variations in root canal anatomy with high prevalence of middle mesial canals. Clinicians should be aware of such anatomical variations for successful root canal treatment procedures. A specific access refinement protocol and appropriate shaping parameters should be designated for each case to fulfil the mechanical and biological objectives of root canal treatment without compromising the longevity of treated teeth.

Cleaning and disinfection of the root canal system provided by four active supplementary irrigation methods

“…Micro-CT is a nondestructive approach to reconstructing samples on a micrometric and real scale 50 . It is considered the gold standard research device in Endodontics for studying several matters, such as the quality of shaping and cleaning processes 51 , the performance of different obturation techniques 52 , the removal of root canal filling materials 53 , and the root canal anatomy 54 . Therefore, the main strength of the present research was the methodology developed to select the sample that has used both CBCT and micro-CT scanning processes to limit (even if partially) the impacts of the anatomical complexity on the variables studied.…”

The effect of cone beam computerized tomography voxel size and the presence of root filling on the assessment of middle mesial canals in mandibular molar teeth

“…Methods such as root canal staining and tooth clearing [13], conventional and digital radiography [14], radiographic assessment enhanced with contrast medium [15] and micro-computed tomography (micro-CT) [16] have been used to analyze canal morphology. In recent years, cone beam computed tomography (CBCT) has been an essential device for diagnosing and planning endodontic treatments due to its ability to provide accurate three-dimensional views of the internal anatomy of teeth [17,18].…”