Root Canal Morphology of Maxillary First Molars Using Cone Beam Computed Tomography

Abstract

Aim: To determine the incidence of variation in canal anatomy of maxillary posterior teeth in patients in Chennai using non invasive Cone Beam Computerized Tomography. Background: The success of endodontic therapy is determined largely by a good understanding, cleaning and shaping of the canal anatomy followed by effective obturation. In the past, this was achieved primarily by endodontic exploration although conventional radiography did help when multiple angles were used. The onset of CBCT provides the opportunity to assess canal anatomy 3-dimensionally in a non-invasive manner. The advances in CBCT technology that have resulted in reduced radiation have also made it practical to use CBCT for diagnostic assessment of canal morphology. The dentist can then be prepared to explore the pulp chamber at the right depth and location to identify variations in canal anatomy in order to clean them effectively. Results: In the present study, 36 numbers of patients with a total of 60 maxillary first molars were assessed. CBCT's of these patients obtained for other reasons were sourced and a software viewer was used to analyze and record variations in maxillary first molar anatomy. Multiple variations in root morphology, canal numbers and configurations were identified and statistically assessed. The results from this study indicate that 86.6 % of maxillary first molars have at least an extra canal, most commonly in the mesiobuccal root. The Type II and Type III configurations (Vertucci's classification) were observed in 3.3 and 40 % of teeth respectively. The results suggests that there is a high incidence of variation in canal anatomy and morphology in maxillary first molars and emphasize the use of CBCT in endodontic diagnosis in order to achieve better treatment outcomes.