Three-Dimensional Observation and Classification of Root and Root Canal Morphology in Japanese Mandibular Third Molars

Numerous studies have explored root anatomy and root canal morphology variations across ethnic groups, but few have focused on the Jordanian population. This study, aimed to assess the prevalence of root anatomy and canal morphology in permanent teeth of a Jordanian subpopulation using cone-beam computed tomography (CBCT). This part of a four-part series focused on mandibular first and second molar teeth. Subsequent parts will address the root anatomy and canal morphology of (1) mandibular anterior teeth, (2) maxillary molars, and (3) maxillary and mandibular premolars. CBCT scans of 332 mandibular molars from patients treated at The University of Jordan Hospital between June and December 2022 were analysed. Canal configurations were categorized according to Vertucci's classification. The majority of mandibular first and second molars had two roots (96.2% and 85%, respectively), with variations such as a third root or a single C-shaped root. Most mesial roots had two canals (100% of first molars, 98.6% of second molars), and distal roots predominantly had one canal (77.9% of first molars, 97.4% of second molars). The most common mesial canal configuration was type II (68% in first molars, 83.7% in second molars), while type I was most common in distal roots (77.8% in first molars, 97.4% in second molars). No significant gender-related differences were found. The study also revealed asymmetry in root morphology between the right and left sides. The root and canal morphology of Jordanian mandibular molars closely resembled the average features observed in Arab and Caucasian populations.

Objective: This study aimed to evaluate the root number, length, and root canal anatomy of extracted mandibular premolars (MPs) from adolescents in Damascus.Materials and Methods: Immediately after extraction, the root number and maximum length were recorded. Each MP was then radiographed in buccolingual and mesiodistal directions using digital periapical radiographs, and the root canal morphology was classified based on Vertucci's classification. Subsequently, the previous findings were correlated with the patient's gender, and statistical analysis was performed using the Chi-Square test and T-test in the SPSS program.Results: The sample included 216 first MPs and 132 second MPs. No significant differences were found between males and females regarding the frequency of one, two, or three roots. Most premolars had a single root. The mean length of the first MP was 21.9 mm, and the second MP was 21 mm, with males generally having longer MPs than females. There were no significant gender differences in the distribution of Vertucci types across MPs. Type I was the most common root canal configuration, followed by Type V. While Types IV and V were similarly prevalent in second MPs, Type V was more common in first MPs.Conclusion: Variations in root number and canal classifications are evident in MPs. Although gender does not influence the root number or canal morphology, males tend to have longer MPs.

Background and Objectives: Adequate knowledge about the number of roots, canals, and morphology of lower first molar teeth is a basic requirement of root canal therapy and any surgical treatment in this region, was carried out to investigate root and canal morphology of permanent mandibular first molars in a sample from Erbil population using cone beam computed tomography (CBCT). Methods: This study carried out during a period from October 2017 till June 2018. The sample selected from patients visited (college of Dentistry, Denta Plus, Hollywood Smile Design) centers in Erbil city according to specific criteria. One hundred patients have been selected from those patients who referred to obtain CBCT for the lower mandibular region, after obtaining consent from these patients and about 141 mandibular first molar teeth were used in this study. Different measurements were done on the CBCT of each patient by investigating the root numbers, the number of canals and root canal configuration which classified by using Wein’s and Vertucci’s classification. The data were analyzed statistically by Pearson’s Chi-square. Results: The result indicated that the first molar tooth had two roots one mesial and one distal, while about the numbers of extra roots the result indicated that only the distal root showed five extra roots (3.5%). The data analysis for the number of canals in study sample indicated that the mesial root had two canals in all sample while in distal root showed that 41 mandibular first molars showed two canals which were about 29.1% and 100 mandibular first molars showed one canal which was about 70.9%. The result indicated that morphology of distal root canal of mandibular first molars according to Wein’s classification, it that 70.9% of the study sample was of type I morphology, both type II and type IV were about 5% of the sample, type III morphology about 12.8%, and about 6.4% of study sample classified according to Vertucci classification which showed type III morphology while for the morphology of mesial root canal of lower first molar tooth the result indicated that 100% of the samples had type III Wein’s morphology. Conclusion: The prevalence of extra root was about 3.5% in distal root. Wein’s type I the most prevalent configurations in distal root and type III Wein’s in the mesial root of the first mandibular molars. CBCT analysis of root canal system provides information and details which is very helpful in different treatment modalities.

ObjectiveThis study aimed to assess the root number, length, and root canal morphology of extracted mandibular premolars (MPs) from adolescents in Damascus using two classification systems: Vertucci’s classification and Ahmed’s classification. This was conducted through radiographic examination utilizing Cone Beam Computed Tomography (CBCT) and digital dental radiography analysis. Additionally, the study sought to investigate the correlation between these variables and gender within the sample.Materials and methodsImmediately after extraction, the root number and maximum length were recorded. Each MP was then radiographed in buccolingual and mesiodistal directions using digital periapical radiographs. Subsequently, MPs were scanned using a CBCT device (200 μm voxel size) and the root canal morphology was classified based on Vertucci’s classification and Ahmad’s classification based on both radiographs. Moreover, the presence of C-shaped canals was investigated and classified according to the Fan et al. classification. Finally, the previous findings were correlated with the patient’s gender, and statistical analysis was performed using the Chi-Square test and T-test in the SPSS program. The confidence interval used for the Chi-square test was 95%. Moreover, the sensitivity, accuracy, specificity, and overall agreement tests was performed to compare digital sensor radiographs with the gold standard CBCT radiographs.ResultsThe sample included 255 first MPs and 163 s MPs. No significant differences were found between males and females regarding the frequency of one, two, or three roots in the first and second MPs (p = 0.931 and p = 0.010, respectively). Most MPs had a single root. The mean length of the first MP was 21.9 mm, and the second MP was 21 mm, with males generally having longer MPs than females (p < 0.001). There were no significant gender differences in the distribution of first and second MPs according to Vertucci and Ahmed classifications (p > 0.05). Type I (1TN1) was the most common root canal morphology, followed by Type V (1TN1–2). Low occurrence of C-shape canals was observed in first and second MPs (4.31% and 9.82%, respectively). The sensitivity, specificity, accuracy, and overall agreement between the two radiographic assessment techniques of both MPs were highly comparable.ConclusionIt can be concluded that variations in root number and canal classifications are evident in MPs. Although gender does not influence the root number or canal morphology, males tend to have longer MPs. Moreover, it is noteworthy that digital sensors performed better in detecting small accessory canals in the apical third.

BackgroundWe investigated the root canal curvature and morphology of maxillary posterior teeth in Guizhou, China, to provide references for clinical practice.Material/MethodsWe collected 274 maxillary posterior teeth in Guizhou Province, China. The root canal curvature was observed by X-ray film measurement. Two hundred teeth were selected to make transparent tooth models, and root canal configuration was recorded according to Vertucci classification criteria. The position of the MB2 root canal orifice and the mesiobuccal root canal configuration were observed by micro-computed tomographic (micro-CT) scanning. The t test and the chi-square test were used for statistical analysis.ResultsThe root canals of the maxillary posterior teeth showed more significant curvature in the mesiodistal direction than in the buccolingual direction (P<0.05). The MB2 root canal of maxillary molars showed severe bending in the mesiodistal direction: 25.16±6.6 degrees and 28.05±8.65 degrees in first and second molars, respectively. The detection rate of MB2 was 48% in maxillary first molars and 32% in maxillary second molars. The results of micro-CT showed that the vertical distances between the MB2 and MB-P line were 0.64±0.34 mm and 0.57±0.28 mm in first and second molars, respectively.ConclusionsThe root canal morphology and curvature of maxillary posterior teeth varied greatly in the Guizhou population, which increases the difficulty of treatment. It is necessary for clinicians to gain understanding of the root canal and to improve the success rate of root canal therapy.

Microorganisms in untreated or overlooked root canals can cause endodontic failure or infection and inflammation. Therefore, clinicians should familiarize themselves with patient's root canal anatomy and morphology. The objective of this retrospective study was to analyze and characterize mandibular root canal morphology using cone beam computed tomography (CBCT) in a Turkish Cypriot population. This cross-sectional study consisted of retrospective evaluation of CBCT scans from 272 adult patients (aged 16-80years). The number of roots and canals and the canal configuration in each root were evaluated using Vertucci's classification. The incidence of additional roots and of C-shaped canals in the mandibular first and second molars was also noted. Pearson chi-square tests were performed to analyze canal configurations, laterality, and gender (p≤0.05). For the female and male patients, 94.5 and 94.4% of the mandibular first and 96.7 and 97.2% of the mandibular second molars had two roots, respectively. In females, 4.4% of mandibular first molars had three roots versus 2.7% of mandibular first molars in male patients. Type IV was the most prevalent canal configuration regardless of the gender (female 61.3% and male 64.2%) in the mesial roots. No statistically significant differences according to gender or laterality were found in the incidence of additional canals for either maxillary first or second molars. Type IV was the most prevalent canal configuration of both the mandibular first and second molar teeth. There was a low prevalence of three-rooted mandibular molars in this particular population. The current study is the first of its kind to include a Turkish Cypriot population and, thus, provides baseline data for these patients regarding appropriate root canal treatments.

To investigate the root form and canal morphology of mandibular first molar teeth in a Taiwan Chinese population. A total of 183 mandibular first molars were collected and examined visually through a dissecting microscope after rendering the teeth transparent. The number of roots, number of canals and canal configuration were recorded. The root canal morphology was categorized and compared according to Vertucci (1984). Overall 46% of the mandibular first molars had four canals and 20% had extra-distal roots (distolingual root). In addition, 97% of the specimens had two mesial canals and 46% had two distal canals. In total, 68% of teeth with two mesial canals had two separated apical foramina, and 33% of teeth with two distal canals had two apical foramina. The most common canal configurations (Vertucci, 1984) of mesial roots were type 4 (46%) and type 2 (23%). Type 1 was encountered in 54% of the distal roots. The frequency of the extra-distal root on the mandibular first molar was 20%, and the incidence of three canals (Vertucci's type 8 classification) with separate apical foramina at the apex of the mesial root was 6%. The three-rooted variation of the mandibular first molar appears to be a genetic characteristic of an Asiatic racial background.

Root canal morphology and symmetry of mandibular second premolars using cone-beam computed tomography.

BackgroundThe study's goal was to use Cone Beam Computed Tomography (CBCT) to assess the root and root canal anatomy of mandibular second molars with C-shaped root canal configurations in residents of the Hail district. The impact of gender and side on the frequency of root canal morphology was considered.MethodsThe sample size for this study was 304 untreated mandibular second molars with completely developed roots on the right and left sides. Using CBCT on the teeth, the root form and canal morphology for each root are based on Vertucci's classification. The occurrence of canals in the shape of a C. The prevalence and resemblance of the left and right sides or men and females were investigated. The Chi-square test was performed to evaluate the findings.ResultsOf the 304 mandibular second molars studied, 286 teeth had two roots (94.1%), whilst 13 (4.3%) were C-shaped root canal systems. 77 molars (25.3%) had two canal orifices, 219 (72.0%) had three canal orifices, and six (2.0%) and one (0.3%) had four and five root canal orifices, respectively. Type IV was the most common for mesial root, accounting for 57.7% of the sample (n = 176). For distal root, the most common occurrence was type I, which occurred 282 times (96.60%). The most prevalent root canal morphology was the presence of two canals in the mesial root and one canal in the distal root of teeth with two distinct roots (variant 3). (69.4%). The overall prevalence of C-shaped root canal systems is (4.3%) (n = 13).ConclusionsThe patient's race is an undeniable factor that influences root canal anatomy. The root canal morphology of mandibular second molars revealed significant differences between Saudi subpopulations. The majority of mandibular second molars had two roots and three root canals. When treating these molars, the presence of a C-shaped root canal system must be taken into account.

Understanding the variations in root canal morphology is important for successful endodontic treatment. Mandibular first premolars have a single root in 98% of cases, and multiple root canals are found in approximately 20% of cases. However, the details of these characteristic findings in panoramic radiography and their diagnostic accuracy are unknown. This study aimed to investigate the characteristic radiographic findings of mandibular first premolars possessing multiple root canals and determine the diagnostic accuracy using panoramic radiography. Four radiologists evaluated 347 mandibular first premolars in 186 patients who underwent panoramic radiography and dental cone beam computed tomography (CBCT). Two radiologists confirmed the existence of single or multiple root canals using CBCT. The remaining two radiologists evaluated the imaging findings of the root canal morphology and classified them into two patterns: gradual narrowing and sudden narrowing. In the case of the sudden narrowing pattern, the location of sudden narrowing was also evaluated. A gradual narrowing pattern was observed in 56% of teeth with a single root canal, and a sudden narrowing pattern was observed in 83% of teeth with multiple root canals. When sudden narrowing between the cervical and apical 1/4 of the root canal was used as the diagnostic criterion for multiple root canal teeth, the highest diagnostic performance was observed (sensitivity, 76.1%; specificity, 73.9%). The sudden narrowing between the cervical level and the apical 1/4 level of the root canal is a practical diagnostic criterion for mandibular first premolar with multiple root canals.

The goal of the present article is to illustrate and analyze the applications and the potential of microcomputed tomography (micro-CT) in the analysis of tooth anatomy and root canal morphology. The authors performed a micro-CT analysis of the following different teeth: maxillary first molars with a second canal in the mesiobuccal (MB) root, mandibular first molars with complex anatomy in the mesial root, premolars with single and double roots and with complicated apical anatomy. The hardware device used in this study was a desktop X-ray microfocus CT scanner (SkyScan 1072, SkyScan bvba, Aartselaar, Belgium). A specific software ResolveRT Amira (Visage Imaging) was used for the 3D analysis and imaging. The authors obtained three-dimensional images from 15 teeth. It was possible to precisely visualize and analyze external and internal anatomy of teeth, showing the finest details. Among the 5 upper molars analyzed, in three cases, the MB canals joined into one canal, while in the other two molars the two mesial canals were separate. Among the lower molars two of the five samples exhibited a single canal in the mesial root, which had a broad, flat appearance in a mesiodistal dimension. In the five premolar teeth, the canals were independent; however, the apical delta and ramifications of the root canals were quite complex. Micro-CT offers a simple and reproducible technique for 3D noninvasive assessment of the anatomy of root canal systems.

Evaluation of root and root canal morphology in maxillary premolar teeth: A cone-beam computed tomography study using two classification systems in a Japanese population

This study aims to investigate the root canal morphology of permanent mandibular second molars of an Indian population in vivo using cone-beam computed tomography (CBCT) images. CBCT images (n=983; males=489, females=494) of untreated, completely developed permanent mandibular second molar teeth were examined. CBCT scans were acquired as part of diagnosis and treatment planning for treatments unrelated to the present study. The number of roots and root canals were recorded. Canal configuration was classified based on Vertucci's and Fan's classifications. The most common configuration was two-root (79.35%) and three-root canals (53.50%). The incidence of three-rooted molars was 7.53%, whereas 13.12% of the studied teeth studied have fused roots with C-shaped canals. The predominant canal morphology in the mesial roots was Vertucci's type IV (45.17%), followed by type II (32.55%), type I (7.23%), type V (1.02%), and type III (0.91%). The distal root in contrast showed type I (61.14%) as the predominant canal configuration, followed by type II (18.21%) and type IV (7.53%). The incidence of three-rooted molars was higher in males (n=55; 5.59%) than in females (n=19; 1.94%) (p<0.01). The canals in the extra roots exhibited type I (100%) root canal morphology. In teeth with C-shaped root canal (13.12%), the variations in the coronal, middle, and apical third ranged from C1 to C4. Root canal systems of the mesial roots of mandibular second molars of the study population demonstrated a high degree of variability. While three roots were rare, there was a sexual predisposition. Fused roots with C-shaped canals were rare and demonstrated significant variations from the coronal to apical third. Root canal morphology can demonstrate variations based on race and sex of patients. Clinicians must always consider the possible variations to ensure successful endodontic treatment.

BackgroundThe study's objective was to use CBCT to ascertain the root and root canal anatomy of the permanent maxillary first molars in a Yemeni population. It was considered how gender affected the prevalence of root canal morphology.MethodsA sample of 373 CBCT records of maxillary permanent first molars belonging to 373 Yemeni individuals (162 males and 211 females) aged between 12 and 65 years were included in this study. Using CBCT on the teeth, the root form and canal morphology for each root based on Vertucci's classification were evaluated. The distribution of MB2 occurrence was documented. The prevalence and resemblance of the men and females were investigated. The Chi-square test was performed to evaluate the findings.ResultsOf the 373 maxillary first molars studied, the three separated root form was found in 94.9% of the studied MFMs while the two fused and one separate root form was found in 4.5%. The majority of the three-rooted MFMs (82.6%) had more than three root canals (four canals in 77.2% and five canals in 5.4%). The prevalence of MB2 was as high as 82.3% of the three-rooted MFMs. Vertucci type II configuration was the most frequent canal type (25%) followed by Vertucci type III (23.1%) and Vertucci type I (17.7%) in the mesiobuccal root. Vertucci type I was the most prevalent canal configuration in the distobuccal root and palatal root of the three-rooted MFMs (96% and 99.5%, respectively).ConclusionsThe maxillary first molars' root canal morphology indicated notable variations among a Yemeni population. The maxillary first molars of most of the Yemeni participants in this study had three roots and four canals. In light of the high occurrence of MB2 (82.3%) in permanent maxillary first molars, our findings emphasize the need of searching for and using cutting-edge techniques to locate the MB2 canals. Males outnumbered females in proportion.

This study was to investigate root anatomy and root canal morphology of mandibular first premolars in a Chinese population. 178 human permanent mandibular first premolars extracted from a native Chinese population were collected, scanned using micro-computed tomography and reconstructed three-dimensionally. The number of roots and canals, canal configuration and radicular grooves were investigated. The root canal morphology was categorized according to Vertucci’s criteria. The radicular grooves were scored according to the Arizona State University dental anthropology scoring system (ASUDAS), and the correlation between scores for radicular grooves and root canal morphology was analyzed. Almost all the samples were single-rooted (99.4%). 64.04% of teeth possessed type I canal systems, whilst 34.27% had two canals and 1.69% had three canals. According to ASUDAS, the scores of radicualr grooves were 56.74%, 16.85%, 12.36%, 10.11%, 3.37% and 0.56% respectively from grade 0 to grade 5. The roots with radicular grooves (grade 3 or 4) were defined as Tome’s anomalous root and these roots have a high incidence of C-shape configurations (66.67%) and multiple-canal systems (100%). There is complicated variation of the root anatomy and canal morphology of mandibular first premolars in southwestern Chinese population, which needs special attention and careful assessment for endodontic treatment.