Cone Beam Computed Tomography – Assisted Morphological Analysis of Mandibular Second Molar’s Root Canals of Thai Subpopulation

Main Article Content

Uthaiwan Arayatrakoollikit
Nutthapong Kantrong
Thalerngsak Samaksaman
Thanat Jarasrungsichol
Itkun Bhudisaksang
Pipop Sutthiprapaporn

Abstract

The aim of this study was to determine root canal morphology of mandibular second molars of Thai subpopulation in northeastern Thailand by using Cone Beam Computed Tomography (CBCT). A total of 215 extracted mandibular second molars were scanned by using CBCT. After three-dimensional reconstruction of the teeth, all studied teeth were subsequently analyzed by WhiteFox Imaging 3.0 computer software. Root canal morphology was categorized by using Fan’s classification and a cross-sectional radiography of canal configurations were investigated at 4 levels of the root canals. Nineteen of 215 mandibular second molars
(8.83%) were identified as C-shaped molars as determined by Fan’s classification. Among C-shaped molars, C1-C5 configurations were detected along root length, despite the highest incidence of C1 (55.50%) at the orifice level. An apical root canal configurational change was found in 6 of 19 teeth (31.57%). Half of non C-shaped molars exhibited two root canals in mesial root with varying number of root canal openings, while the majority of distal roots displayed one root canal with one opening at the apex. In conclusion, we reported a relatively low incidence of finding C-shaped molars in Thai population, despite a high incidence among Asians. Normal anatomy and variations of root canal morphology should necessarily be taken into an account when performing an endodontic treatment in multi-rooted tooth. CBCT is a useful diagnostic tool that might help identify root canal configuration and facilitates clinical procedures.

Article Details

How to Cite
1.
Arayatrakoollikit U, Kantrong N, Samaksaman T, Jarasrungsichol T, Bhudisaksang I, Sutthiprapaporn P. Cone Beam Computed Tomography – Assisted Morphological Analysis of Mandibular Second Molar’s Root Canals of Thai Subpopulation. Khon Kaen Dent J [Internet]. 2019 Jun. 27 [cited 2024 Apr. 18];22(1):60-7. Available from: https://he01.tci-thaijo.org/index.php/KDJ/article/view/157961
Section
Research Articles
Share |

References

Haapasalo M, Udnæs T, Endal U. Persistent, recurrent and acquired infection of the root canal system post-treatment. Endod Topics 2003;6:29-56.

Cooke HG 3rd, Cox FL. C-shaped canal configurations in mandibular molars. J Am Dent Assoc 1979;99:836-9.

Manning SA. Root canal anatomy of mandibular second molars. Part II. C-shaped canals. Int Endod J 1990;23:40-5.

Weine FS. The C-shaped mandibular second molars: incidence and other considerations. J Endod 1998;24:372-5.

Al-Fouzan KS. C-shaped root canal in mandibular second molars in a Saudi Arabian population. Int Endod J 2002;35:499-504.

Haddad GY, Nehme WB, Ounsi HF. Diagnosis, classification, and frequency of C-shaped canals in mandibular second molars in the Lebanese population. J Endod 1999;25: 268-71.

Yang ZP, Yang SF, Lin YC, Shay JC, Chi CY. C-shaped root canals in mandibular second molars in Chinese population. Endod Dent Traumatol 1988;4:160-3.

Seo MS, Park DS. C-shaped root canals of mandibular second molars in a Korean population: clinical observation and in vitro analysis. Int Endod J 2004;37:139-44.

Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. Int Endod J

;35:56-62.

Gulabivala K, Aung TH, Alavi A, Ng YL. Root and canal morphology of Burmese mandibular molars. Int Endod J

;34:359-70.

Jin GC, Lee SJ, Roh BD. Anatomical study of C-shaped canals in mandibular second molars by analysis of computed tomography. J Endod 2006;32:10-3.

Neelakantan P, Subbarao C, Subbarao CV, Ravindranath M. Root and canal morphology of mandibular second molars in an indian population. J Endod 2010;36:1319-22.

Zheng Q, Zhang L, Zhou X, et al. C-shaped root canal system in mandibular second molars in a Chinese population evaluated by cone-beam computed tomography. Int Endod J 2011;44:857-62.

Zhang R, Wang H, Tian YY, Yu X, Hu T, Dummer PM. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals. Int Endod J 2011;44:990-9.

Shemesh A, Levin A, Katzenell V, et al. C-shaped canals – prevalence and root canal configuration by cone beam computed tomography evaluation in first and second mandibular molars – a cross-sectional study. Clin Oral Investig 2017;21:2039-44.

Alfawaz H, Alqedairi A, Alkhayyal AK, Almobarak AA, Alhusain MF, Martins JNR. Prevalence of C-shaped canal system in mandibular first and second molars in a Saudi population assessed via cone beam computed tomography: a retrospective study. Clin Oral Investig 2019;23:107-12.

Fernandes M, de Ataide I, Wagle R. C-shaped root canal configuration: A review of literature. J Conserv Dent 2014;17:312-9.

Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam computed tomography in the

management of endodontic problems. Int Endod J 2007;40:818-30.

Sonick M, Abrahams J, Faiella RA. A comparison of the accuracy of periapical, panoramic, and computerized

tomographic radiographs in locating the mandibular canal. Int J Oral Maxillofac Implants 1984;9:455-60.

Zhang R, Yang H, Yu X, Wang H, Hu T, Dummer PM. Use of CBCT to identify the morphology of maxillary permanent molar teeth in a Chinese subpopulation. Int Endod J 2011;44:162-9.

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;43:1990-6.

Studebaker B, Hollender L, Mancl L, Johnson JD, Paranjpe A. The Incidence of Second Mesiobuccal Canals Located in Maxillary Molars with the Aid of Cone-Beam Computed Tomography. J Endod 2018;44:565-70.

Silva EJ, Nejaim Y, Silva AI, Haiter-Neto F, Zaia AA, Cohenca N. Evaluation of root canal configuration of maxillary molars in a Brazilian population using cone-beam computed tomographic imaging: an in vivo study. J Endod 2014;40:173-6.

Fan B, Cheung GS, Fan M, Gutmann JL, Bian Z. C-shaped canal system in mandibular second molars: Part I--

Anatomical features. J Endod 2004;30:899-903.

Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984;58:589-99.

Brown T. Developmental aspect of occlusion. Ann Aust Coll Dent Surg 1969;2:61-7.

Kim E, Fallahrastegar A, Hur YY, Jung IY, Kim S, Lee SJ. Difference in root canal length between Asians and

Caucasians. Int Endod J 2005;38:149-51.

Yaacob H, Nambiar P, Naidu MD. Racial characteristics of human teeth with special emphasis on the Mongoloid dentition. Malays J Pathol 1996;18:1-7

Ordinola-Zapata R, Bramante CM, Versiani MA. Comparative accuracy of the Clearing Technique, CBCT and

Micro-CT methods in studying the mesial root canal configuration of mandibular first molars. Int Endod J

;50:90-6.

Kim Y, Perinpanayagam H, Lee JK. Comparison of mandibular first molar mesial root canal morphology using

micro-computed tomography and clearing technique. Acta Odontol Scand 2015;73:427-32.

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;36:1547-51.

Melton DC, Krell KV, Fuller MW. Anatomical and histological features of C-shaped canals in mandibular second molars. J Endod 1991;17:384-8.

Chai WL, Thong YL. Cross-sectional morphology and minimum canal wall widths in C-shaped roots of mandibular molars. J Endod 2004;30:509-12.

Shemesh A, Levin A, Katzenell V. Prevalence of 3- and 4-rooted first and second mandibular molars in the Israeli population. J Endod 2015;41:338-42.

Kim SY, Kim BS, Woo J, Kim Y. Morphology of mandibular first molars analyzed by cone-beam computed tomography in a Korean population: variations in the number of roots and canals. J Endod 2013;39:1516-21.