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CC BY-NC-ND 4.0 · Eur J Dent 2019; 13(01): 082-087
DOI: 10.1055/s-0039-1688736
Original Article
Dental Investigation Society

Root Anatomy and Canal Configuration of Maxillary Molars in a Brazilian Subpopulation: A 125-μm Cone-Beam Computed Tomographic Study

Nelson Tsutomu Mohara
1   Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
,
Marcelo Santos Coelho
1   Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
,
Nathalia Valle de Queiroz
2   Department of Endodontics, State University of Campinas, Piracicaba, SP, Brazil
,
Marcelle Louise Sposito Borreau
1   Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
,
Marko Massao Nishioka
2   Department of Endodontics, State University of Campinas, Piracicaba, SP, Brazil
,
Adriana de Jesus Soares
2   Department of Endodontics, State University of Campinas, Piracicaba, SP, Brazil
,
Marcos Frozoni
1   Department of Endodontics, São Leopoldo Mandic School of Dentistry, Campinas, SP, Brazil
› Author Affiliations
Further Information

Publication History

Publication Date:
06 June 2019 (online)

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Abstract

Objective Knowledge of internal anatomy of the teeth is of great importance in endodontics, leading to success in root canal therapy (RCT). The aim of this study was to assess the root anatomy and canal configuration of maxillary molars in a Brazilian subpopulation using tomographic images using a voxel size of 125 μm.

Materials and Methods This in vivo retrospective study assessed 651 cone-beam computed tomographic scans from 328 maxillary first molars and 323 maxillary second molars. The images were assessed by two endodontists and an oral radiologist. Only permanent molars with fully developed roots and with no signs of RCT were included.

Results Maxillary first and second molars presented three separated roots in 99.39 and 90.09% of the cases, respectively. The presence of mesiolingual canals in the mesiobuccal roots was 64.22% for maxillary first molars and 33.56% for maxillary second molars. Distobuccal canals in the maxillary first and second molars presented Vertucci's Type I configuration in 99.39 and 99.66%, respectively, and palatal canals in the maxillary first and second molars presented Vertucci's Type I configuration in 99.69 and 99.68%, respectively. Maxillary second molars were more subjected to anatomical variations than first molars. Female patients presented higher prevalence of mesiolingual canals in the maxillary second molars.

Conclusions The most prevalent morphology in the maxillary first and second molars was three root canals. The presence of only one or two roots is more likely to occur in the maxillary second molars than in the maxillary first molars. Mesiolingual canals in mesiobuccal roots are more frequent in the maxillary first molars than in the maxillary second molars, and the occurrence of two distobuccal or two palatal canals is rare.

Keywords

canal configuration - cone-beam computed tomography - maxillary molars - morphology - root anatomy - root canal therapy
 

  • References

  • 1 Song M, Kim HC, Lee W, Kim E. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod 2011; 37 (11) 1516-1519
    CrossrefPubMedSearch in Google Scholar
  • 2 Kulild JC, Peters DD. Incidence and configuration of canal systems in the mesiobuccal root of maxillary first and second molars. J Endod 1990; 16 (07) 311-317
    CrossrefPubMedSearch in Google Scholar
  • 3 Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod 2006; 32 (09) 813-821
    CrossrefPubMedSearch in Google Scholar
  • 4 Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984; 58 (05) 589-599
    CrossrefPubMedSearch in Google Scholar
  • 5 Wolf TG, Paqué F, Woop AC, Willershausen B, Briseño-Marroquín B. Root canal morphology and configuration of 123 maxillary second molars by means of micro-CT. Int J Oral Sci 2017; 9 (01) 33-37
    CrossrefPubMedSearch in Google Scholar
  • 6 Gilles J, Reader A. An SEM investigation of the mesiolingual canal in human maxillary first and second molars. Oral Surg Oral Med Oral Pathol 1990; 70 (05) 638-643
    CrossrefPubMedSearch in Google Scholar
  • 7 Stropko JJ. Canal morphology of maxillary molars: clinical observations of canal configurations. J Endod 1999; 25 (06) 446-450
    CrossrefPubMedSearch in Google Scholar
  • 8 Sempira HN, Hartwell GR. Frequency of second mesiobuccal canals in maxillary molars as determined by use of an operating microscope: a clinical study. J Endod 2000; 26 (11) 673-674
    CrossrefPubMedSearch in Google Scholar
  • 9 Patel S, Durack C, Abella F, Shemesh H, Roig M, Lemberg K. Cone beam computed tomography in Endodontics – a review. Int Endod J 2015; 48 (01) 3-15
    CrossrefPubMedSearch in Google Scholar
  • 10 Brüllmann DD, Weichert CI, Daubländer M. Intraoral cameras as a computer-aided diagnosis tool for root canal orifices. J Dent Educ 2011; 75 (11) 1452-1457
    CrossrefPubMedSearch in Google Scholar
  • 11 Parker J, Mol A, Rivera EM, Tawil P. CBCT uses in clinical endodontics: the effect of CBCT on the ability to locate MB2 canals in maxillary molars. Int Endod J 2017; 50 (12) 1109-1115
    CrossrefPubMedSearch in Google Scholar
  • 12 Vizzotto MB, Silveira PF, Arús NA, Montagner F, Gomes BP, da Silveira HE. CBCT for the assessment of second mesiobuccal (MB2) canals in maxillary molar teeth: effect of voxel size and presence of root filling. Int Endod J 2013; 46 (09) 870-876
    CrossrefPubMedSearch in Google Scholar
  • 13 Pérez-Heredia M, Ferrer-Luque CM, Bravo M, Castelo-Baz P, Ruíz-Piñón M, Baca P. Cone-beam computed tomographic study of root anatomy and canal configuration of molars in a Spanish population. J Endod 2017; 43 (09) 1511-1516
    CrossrefPubMedSearch in Google Scholar
  • 14 Ratanajirasut R, Panichuttra A, Panmekiate S. A cone-beam computed tomographic study of root and canal morphology of maxillary first and second permanent molars in a Thai population. J Endod 2018; 44 (01) 56-61
    CrossrefPubMedSearch in Google Scholar
  • 15 Zheng QH, Wang Y, Zhou XD, Wang Q, Zheng GN, Huang DM. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. J Endod 2010; 36 (09) 1480-1484
    CrossrefPubMedSearch in Google Scholar
  • 16 Guo J, Vahidnia A, Sedghizadeh P, Enciso R. Evaluation of root and canal morphology of maxillary permanent first molars in a North American population by cone-beam computed tomography. J Endod 2014; 40 (05) 635-639
    CrossrefPubMedSearch in Google Scholar
  • 17 Ghobashy AM, Nagy MM, Bayoumi AA. Evaluation of root and canal morphology of maxillary permanent molars in an Egyptian population by cone-beam computed tomography. J Endod 2017; 43 (07) 1089-1092
    CrossrefPubMedSearch in Google Scholar
  • 18 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 (02) 173-176
    CrossrefPubMedSearch in Google Scholar
  • 19 Reis AG, Grazziotin-Soares R, Barletta FB, Fontanella VR, Mahl CR. Second canal in mesiobuccal root of maxillary molars is correlated with root third and patient age: a cone-beam computed tomographic study. J Endod 2013; 39 (05) 588-592
    CrossrefPubMedSearch in Google Scholar
  • 20 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 (02) 162-169
    CrossrefPubMedSearch in Google Scholar
  • 21 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 (04) 565-570
    CrossrefPubMedSearch in Google Scholar
  • 22 Gambarini G, Piasecki L, Ropini P, Miccoli G, Di Nardo D, Testarelli L. Cone-beam computed tomographic analysis on root and canal morphology of mandibular first permanent molar among multiracial population in Western European population. Eur J Dent 2018; 12 (03) 434-438
    Thieme ConnectPubMedSearch in Google Scholar
  • 23 Beacham JT, Geist JR, Yu Q, Himel VT, Sabey KA. Accuracy of cone-beam computed tomographic image interpretation by endodontists and endodontic residents. J Endod 2018; 44 (04) 571-575
    CrossrefPubMedSearch in Google Scholar
  • 24 Parker JM, Mol A, Rivera EM, Tawil PZ. Cone-beam computed tomography uses in clinical endodontics: observer variability in detecting periapical lesions. J Endod 2017; 43 (02) 184-187
    CrossrefPubMedSearch in Google Scholar
  • 25 Khosravifard N, Kajan ZD, Hasanpoor H. Cone beam computed tomographic survey of the mesiobuccal root canal anatomy in the maxillary first and second molar teeth of an Iranian population. Eur J Dent 2018; 12 (03) 422-427
    Thieme ConnectPubMedSearch in Google Scholar
  • 26 Plotino G, Tocci L, Grande NM. et al. Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: a cone-beam computed tomography study in vivo. J Endod 2013; 39 (12) 1545-1548
    CrossrefPubMedSearch in Google Scholar
  • 27 Martins JNR, Marques D, Mata A, Caramês J. Root and root canal morphology of the permanent dentition in a Caucasian population: a cone-beam computed tomography study. Int Endod J 2017; 50 (11) 1013-1026
    CrossrefPubMedSearch in Google Scholar
  • 28 Maret D, Telmon N, Peters OA. et al. Effect of voxel size on the accuracy of 3D reconstructions with cone beam CT. Dentomaxillofac Radiol 2012; 41 (08) 649-655
    CrossrefPubMedSearch in Google Scholar
  • 29 Bauman R, Scarfe W, Clark S, Morelli J, Scheetz J, Farman A. Ex vivo detection of mesiobuccal canals in maxillary molars using CBCT at four different isotropic voxel dimensions. Int Endod J 2011; 44 (08) 752-758
    CrossrefPubMedSearch in Google Scholar
  • 30 Hartwell G, Appelstein CM, Lyons WW, Guzek ME. The incidence of four canals in maxillary first molars: a clinical determination. J Am Dent Assoc 2007; 138 (10) 1344-1346
    CrossrefPubMedSearch in Google Scholar
  • 31 Coelho MS, Parker JM, Tawil PZ. Second mesiobuccal canal treatment in a predoctoral dental clinic: a retrospective clinical study. J Dent Educ 2016; 80 (06) 726-730
    CrossrefPubMedSearch in Google Scholar
  • 32 Fogel HM, Cunha RS. Maxillary first molars with 2 distobuccal canals: a case series. J Endod 2017; 43 (11) 1925-1928
    CrossrefPubMedSearch in Google Scholar
  • 33 Fogel HM, Peikoff MD, Christie WH. Canal configuration in the mesiobuccal root of the maxillary first molar: a clinical study. J Endod 1994; 20 (03) 135-137
    CrossrefPubMedSearch in Google Scholar
  • 34 De Moor RJ. C-shaped root canal configuration in maxillary first molars. Int Endod J 2002; 35 (02) 200-208
    CrossrefPubMedSearch in Google Scholar
  • 35 Jo H, Min JB, Hwang HK. Analysis of C-shaped root canal configuration in maxillary molars in a Korean population using cone-beam computed tomography. Restor Dent Endod 2016; 41 (01) 55-62
    CrossrefPubMedSearch in Google Scholar
  • 36 Martins JN, Mata A, Marques D, Caramês J. Prevalence of root fusions and main root canal merging in human upper and lower molars: a cone-beam computed tomography in vivo study. J Endod 2016; 42 (06) 900-908
    CrossrefPubMedSearch in Google Scholar