METHODS TO STUDY ROOT CANAL ANATOMY: A SYSTEMATIC REVIEW

Abstract

Introduction: A variety of methods has been used to study the root canal anatomy. Before radiography became rmly established in dental practice, techniques such as injection-moulded models, diaphanization, and sectioning were used to study the internal anatomy of teeth. Twodimensional radiography was a convenient method to study the root canal anatomy, but it provided limited information due to distortion, superimposition, and lack of 3-dimensional information. Cone beam computed tomography, and more recently micro-CT have been used in most of the recent studies on root canal anatomy as they are non-invasive and provide multiplanar data. Each of these methods has its own merits and knowing when to choose which method whilst planning a study is important. Methods: The systematic review was registered in PROSPERO. Three electronic databases were accessed, and a hand search was performed in peer-reviewed journals in endodontics. Studies that met the pre-dened inclusion and exclusion criteria were selected or rejected, respectively. The screened articles were subjected to Risk of Bias (ROB) assessment for evaluation of their scientic merit. Results: The selected studies included data from at least 288478 teeth studied, of which, 206270 teeth were studied by CBCT, 30980 teeth were studied by clearing technique, 3616 teeth were studied by sectioning, 9027 teeth were studied by Micro CT, and 1191 teeth were studied by resin or plastic inltration. The commonest parameters studied were canal morphology, presence as well as morphology of MB2 canals in maxillary molars, C-shaped canal morphology in mandibular molars, presence of extra roots and canals, isthmuses, and racial characterisation of the study population. Conclusion: With the advent of 3-dimensional radiographic techniques such as CBCT and micro-CT, these methods have become the mainstay of root canal anatomy studies, especially as these techniques have become less expensive and more widely available. Certain techniques such as clearing are relevant even today as they provide excellent details on the intricacies of the canal system. Depending on the study characteristic to be studied, the appropriate method must be employed.