Use of Cone Beam Computed Tomography to Identify the Morphology of Maxillary and Mandibular Premolars in Chennai Population

Abstract

Objective: The complex root canal anatomy is inherently colonised by microbial flora. Endodontic treatment success is always related to adequate disinfection of the root canal space, which ultimately affects the treatment outcome. A thorough understanding of the external and internal root canal anatomy by using adequately imaging modalities is essential before planning any treatment. The aim of this study was to investigate the number and morphology of the root canals of maxillary and mandibular premolars in Chennai population. Material and Methods: Full-size cone-beam computed tomographic images were randomly collected from 100 patients, resulting in a total of 200 first and 200 second maxillary premolars as well as 200 first and 200 second mandibular premolars. All the eight premolars were analysed in single patients, who underwent cone-beam computed tomography scanning during pre-operative assessment (before implant surgery, orthodontic treatment, diagnosis of dental-alveolar trauma or difficult root canal treatment). Total number of roots and root canals, frequency and correlations between men and women were recorded and statistically analysed by using chi-square tests. The root canal configurations were rated according to the Vertucci’s classification. Results: In the maxillary first premolar group (n = 200), 36.3% had 1 root, 56.7% had 2 roots and 7.0% had 3 roots, with most exhibiting a type IV canal configuration. In the maxillary second premolar group (n = 200), 60% had 1 root, 29.8% had 2 roots and 10.2% had 3 roots, with the majority of single-rooted second premolars exhibiting a type I canal configuration. In the mandibular first premolar group (n = 200), 80.5% had 1 root, 9.8% had 2 roots and 5% had 3 roots. In the mandibular second premolar group (n=200), 90.1% had 1 root, 6.4% had 2 roots and 3.5 % had 3 roots, with most exhibiting a type I canal configuration. No statistical correlation was found between number of roots, gender and tooth position. Conclusion: This cone-beam computed tomographic study confirmed previous anatomical and morphological investigations. Therefore, the possibility of additional root canals should be considered when treating premolars. Keywords: Cone-beam computed tomography; Mandibular; Maxillary; Premolar; Root canal; Morphology.

Root canal morphology of the mandibular second premolar: a systematic review and meta-analysis

“…Comparative gender difference studies are summarized in Table 2 . A higher [ 15 , 22 , 24 , 33 , 36 , 47 ] or similar [ 2 ] frequency of the 1–1–1/1 RCC in female individuals has been reported. A second root in Mn2Ps has been also reported [ 2 , 3 , 6 , 7 , 10 , 11 , 14 , 20 – 23 , 29 , 33 , 34 , 38 , 39 , 41 , 47 ] with a frequency from 0.1 to 8.0% (Fig.…”

“…The results are divided into authors, year and reference number, population, number of teeth investigated, research method employed, root canal configuration frequency (%) and number of roots (%) (Table 1 ). It could be observed that most of the investigated Mn2Ps were single-rooted (89.5–100%) [ 2 , 3 , 6 , 7 , 10 , 11 , 14 – 16 , 18 , 20 – 24 , 27 – 29 , 31 – 35 , 37 – 39 , 41 , 42 , 46 , 47 ], followed by two-rooted Mn2Ps with a frequency lower than 8% [ 2 , 3 , 6 , 7 , 10 , 11 , 14 , 20 – 23 , 29 , 33 , 34 , 38 , 39 , 41 , 46 , 47 ], while three roots were reported only in 0.1 to 3.5% [ 2 , 7 , 33 ]. A 1–1–1/1 RCC is the most frequently observed classification in Mn2Ps (Vertucci’s and Weine’s Type I) with a frequency up to 99.6% [ 21 ].…”

“…Although CBCT does not provide a similar high-resolution root canal morphology detail when compared with micro-CT [ 21 ], its use for this purpose is relatively widespread. More than half of the reviewed studies in this report (Table 1 ) were performed by means of CBCT [ 2 , 3 , 7 , 9 – 12 , 15 – 24 , 26 , 27 , 29 , 33 – 37 , 42 , 47 ]. This type of imaging was introduced by Yu et al [ 42 ] for the investigation of Mn2Ps.…”

“…Two roots were reported in 0.1–8% [ 2 , 3 , 6 , 7 , 29 , 38 , 39 , 41 , 47 ] of the reviewed studies; these are the lowest and highest ones reported by Martins et al [ 20 , 21 , 23 ] and Singh and Pawar [ 39 ], respectively. Three-rooted Mn2Ps were seldom reported in 0.1–3.5% [ 2 , 7 , 33 ]. Rajakeerthi and Nivedhitha [ 33 ] report a relative higher incidence of three-rooted Mn2Ps (3.5%) and RCCs in an Indian population.…”

“…A number of RCC investigations of the Mn2P have been carried out and analyzed with different research methodologies such as clearing [ 4 , 8 , 14 , 17 , 28 , 32 , 36 , 39 ], optical augmentation [ 32 , 44 ], cross-sectioning [ 5 ], radiography [ 5 , 25 , 30 , 38 , 41 , 43 , 46 ], CBCT [ 2 , 3 , 6 , 9 – 12 , 15 – 24 , 26 , 27 , 29 , 33 , 34 , 37 , 42 , 47 ] and dental computed tomography [ 41 ]. To the best of authors’ knowledge, the root canal morphology of Mn2Ps by means of micro-computed tomography (micro-CT) has not been reported.…”