Abstract
Most failures in endodontic treatment of mandibular incisors are due to the presence of a missed canal specifically the lingual. This investigation aimed to examine the root morphology and number of canals in mandibular incisors using cone beam computed tomography (CBCT). Two hundred and seven patients were assessed in terms of their mandibular central and lateral incisors of CBCT. The inclusion criteria were absence of root resorption, coronal restoration or root filling and clarity and optimal resolution of images. According to the Vertucci's classification, number of roots and canals and type of canal were evaluated by two oral and maxillofacial radiologists. In order to data analysis SPSS version 16 and descriptive statistics were implemented. All mandibular incisors had one root. Most central (84.5%) and lateral (78.2%) incisors had a single canal (p= 0.065). The majority of central (54.5%) and lateral (56.5%) incisors were Vertucci's type I (p= 0.102). Prevalence of one canal in males: central (84.8%), lateral (77.9%) and in females: central (84.2%), lateral (78.5%) (p= 0.518). Prevalence of Vertucci's type I in males: central (52.3%), lateral (45.3%) and in females: central (56.1%), lateral (64.4%) (p=0.188). The prevalence of two canals was 15.5% (central) and 21.8% (lateral) in mandibular incisors. The Vertucci's type I was the most typical kinds of mandibular incisors. Considering the limitations of periapical radiography in determining canal morphology, CBCT can be helpful in case of any concern regarding root canal morphology.
Highlights
Teeth with irreversible pulpitis can be preserved by endodontic treatment [1]
The canal branches again into three separate canals with distinct apical foramina [3]. Several methods such as tooth sectioning, computed tomography (CT) scan, clearing technique and dyes are used for assessment of root canal morphology in vitro [6]
The use of Cone beam computed tomography (CBCT) imaging in endodontics should be limited to the assessment and treatment of complex endodontic conditions, such as the following: Identification of potential accessory canals in teeth with suspected complex morphology, Identification of root canal system anomalies and determination of root curvature, Diagnosis of dental periapical pathosis in patients who present with contradictory or nonspecific clinical signs and symptoms or conventional radiographic findings, Diagnosis of pathosis of nonendodontic origin, Intraoperative or postoperative assessment of endodontic treatment complications, Diagnosis and management of dentoalveolar trauma, Localization and differentiation of external from internal root resorption or invasive cervical resorption, Pre-surgical case planning to determine the exact location of root apex or apices and to evaluate the proximity of adjacent anatomic structures [7]
Summary
Teeth with irreversible pulpitis can be preserved by endodontic treatment [1]. In endodontic treatment, some root canals may remain undetected due to inadequate knowledge about root canal anatomy or insufficient investigations on additional canals. The canal branches again into three separate canals with distinct apical foramina [3] Several methods such as tooth sectioning, computed tomography (CT) scan, clearing technique and dyes are used for assessment of root canal morphology in vitro [6]. Considering the significance of adequate knowledge about root morphology and number of canals in mandibular central and lateral incisors, and to increase the success of endodontic treatment and decrease procedural errors, the current study aimed at exploring the root morphology and number of canals in mandibular central and lateral incisors on CBCT scans of patients
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