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Aim. The purpose of this study was to investigate the number of canals and variations in root canal configuration in the mandibular permanent first molar teeth of a Palestinian population using cone-beam computed tomography (CBCT). Methods. A sample of 320 extracted double-rooted mandibular permanent first molars from Palestinian population was col...
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The aim of this study was to evaluate the homogeneity and quality of different obturating systems using cone-beam computed tomography (CBCT).
Materials and Methods
One hundred and twenty extracted maxillary and mandibular molars were included in this study which was decoronated first and then dissected into palatal and distal roots. After work...
An apical scar is a rare healing reaction that sometimes occurs when periapical pathology destroys the vestibular and oral cortical plates. Radiographically, this appears as a periapical radiolucency/rarefaction and can be mistaken for endodontic pathology or other lesions. The presented clinical case in a 31-year-old female patient shows this well...
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This work compared the assessment of clinically relevant parameters by two-dimensional, that is, full-mouth intraoral radiograph (I-O) and panoramic radiograph (OPT), and three-dimensional, that is, cone beam computed tomography (CBCT), imaging methods. Different radiographic images (CBCT, I-O and OPT) were available for a 53-year-old female patien...
Objectives This study aimed to evaluate the efficacy of different instruments (Hyflex, ROTATE, and hand files) and irrigation methods (EndoUltra, EndoActivator, and side-perforated syringe) in the mesial root canal of a mandibular first molar with isthmuses.
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Citations
... The study identified 10 cases classified as Type I and five as Type II. Mukhaimer et al. [26] conducted a comprehensive examination of a sample of 320 roots located within the geographic region of Palestine. The distribution of Vertucci types in mesial roots was seen to be as follows: ...
Introduction and objective: The presence of an additional root, known as a radix, in the lower molars is of significant importance in the context of root canal therapy since it has the potential to contribute to treatment failure. Furthermore, it is imperative to take this circumstance into consideration when doing tooth extraction using a radix. The present study investigated the anatomical characteristics and prevalence rates of radix entomolaris and paramolaris in mandibular molars using cone beam computed tomography.
Materials and methods: Cone beam computed tomography scans of the lower molars of 376 patients were processed through Newtom’s NNT viewer software. Radix type, radix root canal length, radix root curvature, Vertucci's classification of the canal, and gender of patients were recorded. The results of the research were analyzed with chi-squared.
Results: The prevalence of radix was found to be 0.74%, with entomolaris and paramolaris present in 54.54% and 45.46% of cases, respectively. There was no statistically significant difference between the two variables of radix type and gender, as indicated by a p-value of 0.08. The mean curvature and length of the radix root were measured to be 56.63° and 15.09 mm, respectively. The average root curvature in individuals diagnosed with radix entomolaris and paramolaris was found to be 62.33° and 49.80°, respectively. The study found that the root curvature of entomolaris exhibited a statistically significant difference compared to paramolaris (P=0.031). The mean length of the radix entomolaris and paramolaris roots was found to be 15.50 and 14.60 mm, respectively. There was no statistically significant difference observed in the mean root lengths of the various radix types (P=0.37). According to Vertucci's classification, all radixes were classified as type 1.
Conclusion: The investigated population had a low incidence of radix. The curvature of radix entomolaris exhibited a statistically significant increase compared to radix paramolaris. There was no observed correlation between gender and the length of radix roots in relation to the type of radix root.
... The findings of Madani et al., (2017) and Ni et al., (2018) are in disagreement with those of the present study; both of the previous studies found that the most common canal configuration in mesial roots was type IV, followed by type II, whereas in distal roots the most common canal configuration was type I followed by type II. Similarly, Mukhaimer (2014) and Mohammadzadeh Akhlaghi et al., (2017) found that type IV and I canal configurations were the most common among mesial and distal roots in Palestinian and Iranian populations, respectively. Furthermore, de Pablo et al., (2010) performed a systematic review of the root anatomy and canal configuration of the mandibular permanent first molar, and found that the Vertucci type IV canal system was the most common type, followed by type II. ...
Abstract Aim: Endodontic diseases typically affect the mandibular molars. Understanding the
complex morphology of the root canal system and its variations is necessary for successful
endodontic treatment. The aim of this study was to evaluate the morphology of roots and root
canals of mandibular first and second permanent molar teeth in a Kuwaiti population using
cone-beam computed tomography (CBCT).
Materials and methods: CBCT images of 651 mandibular first and second molar teeth were
obtained from specialist government dental centers. The age, sex, root canal configuration, and
number and type of roots were recorded. The data were statistically analyzed.
Results: The most common canal configuration in the mandibular first and second molars was
type II (65.6% and 54.4%, respectively), with no significant difference seen between the sexes
(p = 0.234). The canal configuration was significantly different between the mandibular first and
second molars (p < 0.001). Most teeth had two roots (94.5%); split roots were common (92.6%) and the number thereof varied significantly. Radicular grooves were most common on the lingual
side (4.9%). C-shaped canals were present in 43 (6.60%) teeth. Additionally, one tooth had a confluent
middle mesial canal and nine (1.4%) had radix entomolaris.
Conclusion: Mandibular molars in our Kuwaiti population typically had two split roots with
type II and IV canal configurations. The prevalence rates of C-shaped canals, middle mesial canals,
and radix entomolaris were remarkably low.
... 4 Therefore, to provide a successful treatment outcome, the thorough understanding of the complexity and morphologic variation of the root canal system is required before starting the treatment. 5 Missed canals and incomplete debridement provide a space for microorganisms to grow, which causes the persistence of apical periodontitis. 6 Hence, in this study, careful exploration of the pulp chamber was done under magnification and illumination using dental loupes (3X magnification). ...
Background: The success of root canal therapy depends on proper knowledge of root canal system, presence of extra canals, complete debridement and three-dimensional obturation of the entire root canal system. Previous studies have reported three to five canals in mandibular first molars. There might be chance of missing the canal that may lead to root canal failure, because of the variability in the number of root canals. The objective of this study was to determine the percentage of extra canal in the permanent mandibular first molar in patients undergoing root canal treatment. Methods: This cross-sectional study was conducted in the Department of Conservative Dentistry and Endodontics of Peoples Dental College and Hospital over a period of ten months from 6th September 2021 to 31st July 2022 after receiving ethical clearance from Institutional review Committee (IRC) Peoples dental college on 5th September 2021 (ref no1/ch no 5,2078/2079). About 350 mandibular first molar was selected by convenient sampling. After access preparation, all canal orifices were located and data were recorded. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22.0 with frequency table. Results: Out of 350 patients, the percentage of three canals, four canals and five canals were respectively 273(78%), 76(21.7%) and 1(0.3%). Conclusions: The finding of this study supports the presence of extra canals in mandibular first molar. Thus, the clinicians require more diagnostic approaches, access modifications, and skills to locate, clean and shape the entire root canal system.
... Meanwhile, the method employed to identify MMC exerts an influence on the detection rate which ranges from 1 to 46% [12]. Methods employed for detection include plastic casts [13], clearing [14], scanning electron microscopy [15], cone-beam computed topography(CBCT) [16] microcomputed tomographic (mCT) imaging [17], and troughing using ultrasonics and magnification [12]. ...
The aim of this study was to evaluate the radix entomolaris (RE) and middle mesial canal (MMC) in mandibular permanent first molars in an Iraqi subpopulation using cone-beam computed tomography (CBCT). Their prevalence and types were investigated in 201 patients (301 tooth subjects), among which 156 were of the right side, and 145 of the left side mandibular first molars (MFM), using CBCT scans. The effects of gender, age, and unilateral/bilateral on the presence of both RE and MMC were evaluated. Chi-square and Fisher's exact tests were used to determine the level of significance (p ≤ 0:05), and the kappa value was used to check reliability of results of the research. In MFM, the prevalence of right and left RE was 4.5% and 4.1%, respectively, and it was significantly higher in males than females (p = 0:006) based on the Chi-square test. No significant difference was identified in the prevalence of RE in relation to age and tooth position. MMC was found in 14.7% of teeth in the right side and 19.3% in the left side, with no significant differences for age or gender. MMC merged with mesiolingual canal presented with higher prevalence compared to other types of MMC (8.3% right side and 7.6% left side), again with no significant differences for age or gender. Within the limits of this study, no significant association was detected between the prevalence of MMC and RE in MFM.
... Brazilian [20] 2014 Palestinian An ex vivo, CBCT 320 [21] 2015 Belgian and Chilean Zafar and Alrahabi [23] 2015 Saudi Arabia ...
Understanding root canal anatomy and its variations is an essential part of the success of endodontic treatment. This case report represents an extremely rare occurrence of four distal root canals in a two-rooted mandibular first molar (MFM). Nonsurgical endodontic treatment of MFM was performed with the aid of the dental operating microscope and ultrasonic troughing tips. PubMed database (www.ncbi.nim.nih.gov/pubmed) was searched for relevant articles using specific search terminologies for conducting the literature review. Data extraction was performed in relation with the inclusion and exclusion criteria provided in the study. Quantitative data synthesis was performed. Only four cases (including the present case) of four distal root canals in two-rooted MFMs have been reported in dental literature. Among these, three cases were reported in the Indian population. The overall incidence of four canals in a distal root of two-rooted MFMs is 0.09% according to clinical/laboratory studies. The most common distal root canal configurations of two-rooted MFMs found in clinical/laboratory studies were Vertucci type I (68.15%) followed by type II (37.6%) and type III (35.08%). A meticulous understanding of the anatomical variations, preoperative awareness, and intraoperative care to identify the landmarks of usual as well as any unusual anatomy of the root canal system will help to increase the rate of clinical success.
... It is generally accepted that mandibular first molars have two roots, mesial and distal; three or four canals; two in mesial and one or two in distal root. 2 Variation in the root and canal anatomy of mandibular first molar are common. Various techniques like tooth demineralization and canal staining; cavity preparation and IOPA's with files placed in the canals have been used in the past to determine the root canal morphology. ...
... Raed Hakam Mukhaimer reported the 53.8% prevalence of type-4 canal configuration in mesial root followed by type-2 in 38.8%. 2 In Korean population, Kim et al reported a higher incidence (76.9%) of mesial root with type-4. 2 These higher incidences were also reported by Zhang et al in Chinese population: 81% of mesial roots with type-4. 15 These slight variations in the canal morphology are due to difference in the ethnicity of the population. ...
... Raed Hakam Mukhaimer reported the 53.8% prevalence of type-4 canal configuration in mesial root followed by type-2 in 38.8%. 2 In Korean population, Kim et al reported a higher incidence (76.9%) of mesial root with type-4. 2 These higher incidences were also reported by Zhang et al in Chinese population: 81% of mesial roots with type-4. 15 These slight variations in the canal morphology are due to difference in the ethnicity of the population. ...
... The presence of an extra root canal in the distal root of the mandibular molars is called the middle distal (MD) canal (Gaeˆta-Araujo et al., 2019), which is rarely observed, and its occurrence ranges from 0% to 22.5% (Sperber and Moreau, 1998;Sert et al., 2004;Mukhaimer, 2014;Fabra-Compos, 1985;Cunningham and Senia, 1992;Calis ßkan et al., 1995;Al-Qudah and Awawdeh, 2009;Ahmed et al., 2007;Filpo-Perez et al., 2015;Alashiry et al., 2020). Different methods have been used to detect the presence of MD canals, including radiography (Fabra-Compos, 1985;Cunningham and Senia, 1992), clearing (Sperber and Moreau, 1998;Sert et al., 2004;Calis ßkan et al., 1995;Al-Qudah and Awawdeh, 2009;Ahmed et al., 2007), cone-beam computed tomography (CBCT) (Fabra-Compos, 1985), and micro-computed tomography (Filpo-Perez et al., 2015;Alashiry et al., 2020). ...
... for four root canals (Mashyakhy et al., 2019;Al-Nazhan, 1999). The prevalence rate of the MD canals in this study was 0.7%, which was higher than that of a previous study (0.0%) by Mukhaimer (2014) using CBCT. Other studies had varying prevalence rates of the MD canals due to different methodologies and races in these prior studies (Sperber and Moreau, 1998;Sert et al., 2004;Fabra-Compos, 1985;Cunningham and Senia, 1992;Calis ßkan et al., 1995;Al-Qudah and Awawdeh, 2009;Ahmed et al., 2007;Filpo-Perez et al., 2015;Alashiry et al., 2020). ...
Purpose
The prevalence of the middle distal (MD) canal in the mandibular molar is significantly low among countries including the USA, Spain, Turkey, and Jordan; however, analysis of its prevalence and configuration has not been performed in Saudi Arabia. Therefore, we aimed to assess the prevalence and configuration of the MD canal in Saudi Arabia.
Methods
A retrospective analysis of 132 cone-beam computed tomography (CBCT) images was performed to evaluate the presence of the MD canal in patients visiting the Radiology Department of XXX between July 2018 and July 2019. The canal was examined if it was confluent with the distobuccal (DB) or distolingual (DL) canals, fin, or independent. Moreover, the distances from the MD canal to the DL and DB canals and cementoenamel junction (CEJ) were recorded.
Results
One MD canal (0.7%) was observed in 145 teeth. It was confluent with the DL canal. No statistical significance was observed among sex and age. The distances from the MD canal to the DL canal, DB canal, and CEJ were 1.4 mm, 1.9 mm, and 3.1 mm, respectively.
Conclusions
The prevalence of the MD canal was significantly low in a Saudi subpopulation (0.7%). Careful evaluation of CBCT images and the pulpal floor is significantly important to detect the MD canal to ensure a good prognosis.
... The most common form of a mandibular first molar is the presence of two roots with three canals: two canals located in the mesial root and one canal in the distal root. There is little difference between countries and ethnic groups [5,[29][30][31][32][33]. In our study, the most common root canal configuration of the mandibular first molar was type IV (65.84%) in the mesial roots and type I (78.19%) in the distal roots. ...
... In our study, the most common root canal configuration of the mandibular first molar was type IV (65.84%) in the mesial roots and type I (78.19%) in the distal roots. The result is in accordance with the findings of most earlier studies [5,16,29,[31][32][33][34][35][36][37]. ...
Background:
The aim of this study was to investigate the prevalence of the middle mesial canal (MMC) and radix entomolaris (RE) in mandibular first permanent molars in a western Chinese population using cone-beam computed tomography (CBCT).
Methods:
A total of 1174 CBCT images of the mandibular first molars were collected from West China Hospital of Stomatology, Sichuan University. The following information was recorded and evaluated: the detection rate and location of the MMC and RE, the curvature of the RE, the canal configuration and bilateral symmetry.
Results:
The detection rates of the MMC and RE were 3.41 and 25.04%, respectively, as calculated by individuals, and 1.79 and 22.15%, respectively, as calculated by total teeth. The average curvature in the buccolingual (BL) orientation (40.63 ± 14.39°) was significantly larger than that in the mesiodistal (MD) orientation (17.64 ± 7.82°) (p < 0.05). Of 587 patients, 71.72% (421/587) had bilateral symmetry according to the root canal morphology. The prevalence of three-rooted mandibular first molars was higher in males than in females, while the prevalence of two-rooted mandibular first molars was higher in females than in males.
Conclusions:
Our results showed that the RE could be detected in almost 1/4 of the western Chinese population; thus, RE detection requires special attention and careful assessment in endodontic treatment.
... The most common form of a mandibular first molar is the presence of two roots with three canals: two canals located in the mesial root and one canal in the distal root. There is little difference between countries and ethnic groups [5,[27][28][29][30][31]. In our study, the most common root canal configuration of the mandibular first molar was type IV (65.84%) in the mesial roots and type I (78.19%) in the distal roots. ...
... In our study, the most common root canal configuration of the mandibular first molar was type IV (65.84%) in the mesial roots and type I (78.19%) in the distal roots. The result is in accordance with the findings of most earlier studies [5,16,27,[29][30][31][32][33][34][35]. ...
Background: The aim of this study was to investigate the prevalence of the middle mesial canal (MMC) and radix entomolaris (RE) in mandibular first permanent molars in a western Chinese population using cone-beam computed tomography (CBCT).
Methods: A total of 1174 CBCT images of the mandibular first molars were collected from West China Hospital of Stomatology, Sichuan University. The following information was recorded and evaluated: the detection rate and location of the MMC and RE, the curvature of the RE, the canal configuration and bilateral symmetry.
Results: The detection rates of the MMC and RE were 3.41% and 25.04%, respectively, as calculated by individuals, and 1.79% and 22.15%, respectively, as calculated by total teeth. The average curvature in the buccolingual (BL) orientation (40.63±14.39°) was significantly larger than that in the mesiodistal (MD)orientation (17.64±7.82°) (p<0.05). Of 587 patients, 71.72% (421/587) had bilateral symmetry according to the root canal morphology. The incidence of three-rooted mandibular first molars was higher in males than in females, while the incidence of two-rooted mandibular first molars was higher in females than in males.
Conclusions: Our results showed that the RE could be detected in almost 1/4 of the western Chinese population; thus, RE detection requires special attention and careful assessment in endodontic treatment.
... The most common form of a mandibular rst molar is the presence of two roots with three canals: two canals located in the mesial root and one canal in the distal root. There is little difference between countries and ethnic groups [5,[29][30][31][32][33]. In our study, the most common root canal con guration of the mandibular rst molar was type IV (65.84%) in the mesial roots and type I (78.19%) in the distal roots. ...
... In our study, the most common root canal con guration of the mandibular rst molar was type IV (65.84%) in the mesial roots and type I (78.19%) in the distal roots. The result is in accordance with the ndings of most earlier studies [5,16,29,[31][32][33][34][35][36][37]. ...
Background: The aim of this study was to investigate the prevalence of the middle mesial canal (MMC) and radix entomolaris (RE) in mandibular first permanent molars in a western Chinese population using cone-beam computed tomography (CBCT).
Methods: A total of 1174 CBCT images of the mandibular first molars were collected from West China Hospital of Stomatology, Sichuan University. The following information was recorded and evaluated: the detection rate and location of the MMC and RE, the curvature of the RE, the canal configuration and bilateral symmetry.
Results: The detection rates of the MMC and RE were 3.41% and 25.04%, respectively, as calculated by individuals, and 1.79% and 22.15%, respectively, as calculated by total teeth. The average curvature in the buccolingual (BL) orientation ( 40.63±14.3 9°) was significantly larger than that in the mesiodistal (MD)orientation ( 17.64±7.8 2°) (p<0.05). Of 587 patients, 71.72% (421/587) had bilateral symmetry according to the root canal morphology. The incidence of three-rooted mandibular first molars was higher in males than in females, while the incidence of two-rooted mandibular first molars was higher in females than in males.
Conclusions: Our results showed that the RE could be detected in almost 1/4 of the western Chinese population; thus, RE detection requires special attention and careful assessment in endodontic treatment.
