Prevalence of C-Shaped Canals in Anterior and Posterior Teeth of Iranian Population Using Cone Beam Computed Tomography

Farzaneh Ostevar Rad,Elnaz Mousavi,Nikoo Khatibi,Dina Maleki,Naghmeh Musapoor

doi:10.34172/ajdr.2020.12

Farzaneh Ostevar Rad, Elnaz Mousavi + Show 3 more

Open Access

https://doi.org/10.34172/ajdr.2020.12

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Abstract

Background: Lack of knowledge of root anatomy is the second most common reason for failed endodontic therapy. Therefore, acquiring knowledge about it leads to a more effective treatment. C-shaped canal is an anatomical variation that causes clinical challenges. The objective of this study is to determine the occurrence of the C-shaped roots in permanent anterior and posterior teeth of the Iranian population using CBCT (cone beam computed tomography) scans. Methods: This was a descriptive cross-sectional study. In this study, 1408 teeth were assessed. Cranex 3D Mid was used to prepare CBCT images. Each tooth was examined in axial sections, and five different levels were identified as coronal, medium, apical, 1/3, and 2/3. The canal shapes were classified into 5 categories based on modified Melton’s method. Data were analysed using the chi-square test at a significance level of 5%in SPSS version 24.0. Results: In total, of 1408 teeth which were evaluated, 7.81% (110) were confirmed to have C-shaped canals. The occurrence of the C-shaped canal was significantly higher in molars (P < 0.001). The occurrence of the C-shaped canal was significantly higher in mandibular teeth (10.04%) compared to maxillary teeth (5.81%) (P < 0.001). The most common C-shaped canal category was C1 (57.27%). The relationship of gender and age with the C-shaped canal occurrence was not statistically significant (P = 0.585, P = 0.562, respectively). Conclusions: CBCT is a useful tool to evaluate C-shaped root canal morphology. The high occurrence of the C-shaped canal in the Iranian population requires clinical awareness.

Highlights

Lack of knowledge of root anatomy is the second most common reason for failed endodontic therapy
The preoperative recognition of canal morphology and root anatomy leads to more effective cleaning, shaping, and obturation procedures, thereby improving the long-term prognosis of the treatment (1-4)
Sixteen CBCT images were excluded from the study according to exclusion criteria

Summary

Introduction

Lack of knowledge of root anatomy is the second most common reason for failed endodontic therapy. Conclusions: CBCT is a useful tool to evaluate C-shaped root canal morphology. Lack of information about root anatomy and canal morphology is the second prevalent reason for failed endodontic therapy (1). The preoperative recognition of canal morphology and root anatomy leads to more effective cleaning, shaping, and obturation procedures, thereby improving the long-term prognosis of the treatment (1-4). The root canal system reveals different morphological variations such as C-shaped canal which is reported to cause clinical challenges and to complicate endodontic treatment (5). C-shaped canals were primarily pictured by Keith and Knowles in 1911 and were later defined by Cooke and Cox in 1979 (4,6) This anatomical variation is named C-shaped because of the presence of fin or web connecting the individual canals, leading to a configuration that resembles the letter “C” in a transverse section (4-6). The failure of Hertwig’s epithelial root sheath to fuse on buccal or lingual root surface is claimed

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