Prevalence of C-shaped mandibular molars in the Portuguese population evaluated by cone-beam computed tomography

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Abstract

Objective:

The purpose of this study was to evaluate the prevalence of first and second C-shaped mandibular molars in a Western European population of Portuguese Caucasians.

Materials and Methods:

Patients having both routine panoramic radiograph and presurgical cone-beam computed tomography (CBCT) exams were selected. The CBCT examination was performed at five different axial levels and the mandibular molars were classified as C-shape according to the Fan criteria. Differences between genders, age groups, left and right side, type of tooth, and root concavity side were determined. The molars were classified as nonfused roots (NFRI–II), FRI–III, or single root with single canal (SS) groups, using the panoramic radiograph. The prevalence of C-shaped anatomy was calculated to each group.

Results:

A total of 1783 teeth (695 first molars and 1088 second molars) from 792 patients were included in the study. The prevalence of C-shaped configurations was 0.6% and 8.5% to mandibular first and second molars, respectively. The differences between gender, teeth, and root concavity direction were considered statistically significant ( P < 0.05). The FR had a significantly higher rate of C-shapes when compared to NFR ( P < 0.05). Intrarater reliability was 93.6%.

Conclusions:

The FR radiographic appearance may be considered a predictor of this anatomy. Second mandibular molars and females had a higher incidence ratio. Apparently, the mandibular C-shaped anatomy is more common in the population of this study than that has been previously reported for the European population.

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Most cited references 27

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C-shaped canal system in mandibular second molars: Part I--Anatomical features.

James Gutmann, Gary S P Cheung, Jian-Bing Fan … (2004)

The purpose of this study was to investigate the anatomical features of C-shaped root canal system in mandibular second molars using micro-computed tomography (microCT). Fifty-eight extracted mandibular second molars with fused roots were collected from a native Chinese population. The teeth were scanned into layers of 0.5-mm thickness by microCT and measurements were made at eleven levels. The ratio of the depth of the deepest part of the groove to the buccal-lingual thickness of the cross-section of the root was calculated for each tooth. The canal shapes of the scanned cross-sections were assessed and classified according to a modified Melton's method. Results were subject to the Kruskal-Wallis test. Of the 58 molars, 54 had a C-shaped canal system with a mean groove-to-thickness ratio of 47.96%; the four teeth without a C-shaped canal had a mean ratio of 14.82%. Most orifices (98.1%) were found within 3 mm below the cementoenamel junction. Of teeth with a C-shape canal system, a majority demonstrated an orifice with an uninterrupted "C" configuration. Seventeen canals divided in the apical portion, most of which did so within 2 mm from the apex. The cross-sectional shape varied drastically along the length of the canal. Teeth with a high groove-to-thickness ratio had at least one section with C1, C2, or C3 configuration. The canal shape in middle and apical thirds of C-shaped canal systems could not be predicted on the basis of the shape at the orifice level. Section 2 of this paper addressed the correlation between the radiographic appearance and these microCT images.

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Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals.

Fu-Shin Yu, Hong-Hui Wang, Tina Hu … (2011)

To evaluate the root canal configuration of permanent mandibular first and second molar teeth in a Chinese subpopulation using cone-beam computed tomography (CBCT). Patients who required CBCT radiographic examinations as part of their routine examination, diagnosis and treatment planning, were enrolled. Cases where the anatomy was compromised by physiological or pathological processes and the original root canal morphology was not clear were excluded. A total of 389 healthy, untreated, fully developed mandibular molars in Chinese individuals were included. The following observations were recorded: (i) the number of roots and their morphology; (ii) the number of canals per root; (iii) the canal configuration; (iv) the frequency of distolingual roots in the mandibular first molars and (v) the frequency of C-shaped canals in the mandibular second molars. The root canal configurations were classified according to the method of Vertucci (Oral Surgery, Oral Medicine, and Oral Pathology58, 1984, 589). The majority of mandibular molars (70% of first molars, 76% of second molars) had two separate roots; however, three roots were identified in 29% of first molars. C-shaped roots occurred in 29% of second molars. Three canals were found in 56% of mandibular first molars and 43% had four canals. In the mandibular second molars, 46% had three canals and 38% had two canals. Most distal roots had a simple type I configuration, whereas mesial roots had more complex canal systems, with more than one canal. There were seven variants of the root canal morphology amongst the mandibular first molars and eight variants amongst the mandibular second molars, without considering the various root types. Three-rooted mandibular first molars and C-shaped mandibular second molars occurred frequently in this Chinese population. CBCT is an effective tool for the detection of additional distolingual roots and C-shaped roots/canals, and it is a valuable aid for dentists providing root canal treatment. © 2011 International Endodontic Journal.

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Root and canal morphology of permanent mandibular molars in a Sudanese population.

H. Ahmed, N Abu-bakr, N Yahia … (2007)

To investigate variations in the root canal systems of first and second permanent mandibular molar teeth in a Sudanese population using a clearing technique. Two hundred extracted first and second permanent mandibular molars from three cities in the state of Khartoum were studied. Access cavities were prepared and pulp tissue was removed by immersion in 5% sodium hypochlorite under ultrasonication; Indian ink was then injected into the root canal systems assisted by a vacuum applied apically. The teeth were rendered clear by demineralization and immersion in methyl salicylate before evaluation. The following observations were made (i) number of roots and their morphology; (ii) number of root canals per tooth; (iii) number of root canals per root and (iv) root canal configuration. Overall 59% of mandibular first molars had four canals with 3% having a third distolingual root. Seventy-eight per cent of second mandibular molars had two separate flat roots, whilst 10% were C-shaped. The most common canal system configurations were type IV (73%) and type II (14%). Inter-canal communications were more common in the mesial roots. The prevalence of inter-canal communications was 65% in first molars and 49% in second molars. In this sample of Sudanese teeth, 59% of the mandibular first permanent molars had four root canals whilst 10% of the mandibular second molars had C-shaped roots/canals.

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Author and article information

Journal

Journal ID (nlm-ta): Eur J Dent

Journal ID (iso-abbrev): Eur J Dent

Journal ID (publisher-id): EJD

Title: European Journal of Dentistry

Publisher: Medknow Publications & Media Pvt Ltd (India )

ISSN (Print): 1305-7456

ISSN (Electronic): 1305-7464

Publication date (Print): Oct-Dec 2016

Volume: 10

Issue: 4

Pages: 529-535

Affiliations

[1 ]Department of Endodontics, Implantology Institute, Lisbon, Portugal

[2 ]Department of Biology, New York University, New York, USA

[3 ]Department of Oral Biology, School of Dental Medicine, Lisbon University, Lisbon, Portugal

[4 ]Oral Biology and Biochemistry Group, Biomedical and Oral Sciences Research Unit (FCT Unit 4062)- Evidence Based Dentistry Center, Lisbon University, Lisbon, Portugal

[5 ]Department of Anatomy and Physiology, School of Dental Medicine, Lisbon University, Lisbon, Portugal

[6 ]Department of Implantology, School of Dental Medicine, Lisbon University, Lisbon, Portugal

Author notes

Correspondence: Dr. Jorge N. R. Martins Email: jnr_martins@ 123456yahoo.com.br

Article

Publisher ID: EJD-10-529

DOI: 10.4103/1305-7456.195175

PMC ID: 5166311

PubMed ID: 28042270

SO-VID: e10b06ad-4b12-4387-b316-0b98b317fc9e

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This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Prevalence of C-shaped mandibular molars in the Portuguese population evaluated by cone-beam computed tomography

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Abstract

Objective:

Materials and Methods:

Results:

Conclusions:

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Arab Journal of Forensic Sciences & Forensic Medicine (AJFSFM)

Most cited references 27

C-shaped canal system in mandibular second molars: Part I--Anatomical features.

Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals.

Root and canal morphology of permanent mandibular molars in a Sudanese population.

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