Study of cross-sectional morphology of root canals in Tibetan mandibular incisors by micro-computed tomography

Abstract

Objective: To study the cross-sectional morphology of root canal system of Tibetan mandibular incisors by micro-CT. Methods: From October 2019 to October 2020, one hundred and thirty-six mandibular incisors were collected from Tibetan patients [(51.9±16.4) years old, range from 25 to 80 years] who underwent teeth extraction due to severe periodontitis at the Department of Stomatology, Tibetan Hospital of Traditional Tibetan Medicine, including 84 mandibular central incisors and 52 mandibular lateral incisors. These teeth were scanned at 23 μm voxel size resolution. Root lengths from cemento-enamel junction (CEJ) to apex of mandibular incisors were measured. According to the length, the root was divided as cervical 1/3, middle 1/3 and apical 1/3, and the numbers of root canals were recorded simultaneously. The major diameter, minor diameter, and dimension were measured per millimeter in cross section for mandibular incisor with single root canal, and the ratio of major diameter to minor diameter (Dmax/Dmin) as well as roundness were calculated for morphological analysis. The diversions and conversions from CEJ to apex in cross section were recorded for mandibular incisor with multiple root canals. Results: For mandibular central incisors with single root canal, the Dmax/Dmin was highest in middle 1/3 of the root [1.99 (1.31, 2.79)], which was significantly higher than cervical 1/3 and apical 1/3 (P=0.010, P=0.003). The roundness was least in middle 1/3 [0.47 (0.31, 0.66)], which was significantly lower than cervical 1/3 and apical 1/3 (P=0.010, P=0.001). For mandibular central incisor with multiple root canals, the highest incidence of multiple root canals was 40.5% (34/84), and mainly detected in middle 1/3 of the root [32.1% (27/84)]. For mandibular lateral incisor with single root canal, the roundness was greatest in apical 1/3 of the root [0.61 (0.49, 0.71)], which was significantly higher than cervical 1/3 (P=0.001) and middle 1/3 (P=0.001). The highest incidence of multiple root canals was 34.6% (18/52), all of which were detected in apical 1/3. Conclusions: In Tibetan mandibular central incisors, the cross-sectional morphology of root canals was long and narrow in middle 1/3, and multiple root canals were more likely to be found here. In Tibetan mandibular lateral incisors, the cross-sectional anatomy of root canal was relatively close to circle in apical 1/3, but the shape was still so irregular that one root canal may divide into two here.