Abstract
Purpose Missed additional canals are one of the most important reasons for RCT failures in molar teeth. This study aimed to determine the prevalence and distribution of middle mesial canals in mandibular first molars of the Kerman population. Materials and Methods A retrospective study was performed on de-identified cone beam image sets from 3 private radiology centers in Kerman. A total of 100 mandibular first molars from 62 patients (mean age 32 years) were included. Information regarding the patient's age and gender, the location of teeth, and the presence or absence of a MMC and also a second distal canal in MMC cases was recorded in an Excel table. Data were analyzed using SPSS software (IBM-USA). Results The overall prevalence of MMCs in the mandibular first molars was 8.1% (10.0% in females and 6.3% in males). More cases of MMCs were seen on the right side (12.2%) than the left side (3.4%). One case of bilateral MMCs combined with bilateral second distal canals in the mandibular first molars was seen in a 26-year-old female. A further case of bilateral MMCs was found in a 32-year-old male but with single-canal distal roots on both sides. Conclusion The overall prevalence of MMCs in the Kerman population (8.1%) is at the lower end of the reported range of the international literature (0.26% to 53.8%). In the cohort examined in this study, mid mesial canals were more prevalent in females and on the right side. There was no definite relationship between MMCs and second distal canals in the mandibular first molar teeth in the same subject. MMCs may be unilateral or bilateral. Careful exploration of the pulpal floor between canal orifices is essential to prevent missing the MMC, as this would cause undesirable clinical outcomes.
Highlights
Mandibular permanent molars are the most common teeth requiring endodontic treatment in dental practice. ey play a key role in mastication, so maintaining them is important for effective chewing. e mesial roots of mandibular molars normally have a mesiobuccal (MB) canal and a mesiolingual (ML) canal, whereas their distal roots usually have one centrally placed canal
Martinez-Berna and Badanelli reported a middle canal in the distal root of mandibular first molars [3]. e diameter of a middle mesial canal (MMC) is generally less than that of the two main canals in the mesial root. e mean diameter of the MMC orifice has been reported to be 0.16 mm, three times less than the diameter of the main mesial canal orifices, which is 0.5 mm. e MMC has a much lower overall volume, 0.20 ± 0.10 mm3, in comparison with the MB and ML canals (0.75 ± 0.20 and 0.88 ± 0.19 mm3, respectively) [4]
Other than the cone beam imaging, other methods have been used to look for the presence of MMC in mandibular molar teeth, including troughing the floor of the pulp chamber to locate additional root canal orifices, while using an endoscope or a dental operating microscope [7, 8]
Summary
Prevalence and Distribution of the Middle Mesial Canal in Mandibular First Molar Teeth of the Kerman Population: A CBCT Study. Is study aimed to determine the prevalence and distribution of middle mesial canals in mandibular first molars of the Kerman population. E overall prevalence of MMCs in the mandibular first molars was 8.1% (10.0% in females and 6.3% in males). One case of bilateral MMCs combined with bilateral second distal canals in the mandibular first molars was seen in a 26-year-old female. A further case of bilateral MMCs was found in a 32-year-old male but with single-canal distal roots on both sides. In the cohort examined in this study, mid mesial canals were more prevalent in females and on the right side. Ere was no definite relationship between MMCs and second distal canals in the mandibular first molar teeth in the same subject. Careful exploration of the pulpal floor between canal orifices is essential to prevent missing the MMC, as this would cause undesirable clinical outcomes
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