Use of CBCT to identify the morphology of maxillary permanent molar teeth in a Chinese subpopulation

Abstract

To investigate variations in root canal configuration in the maxillary permanent molar teeth of a Chinese subpopulation using cone-beam computed tomography (CBCT). A total of 269 patients with healthy, untreated, well-developed maxillary molars were enrolled, including those suffering facial trauma, and those who required a pre-operative assessment for implants. Radiographic examination by CBCT was conducted as part of their routine examination, diagnosis and treatment planning. Overall, 299 maxillary first and 210 maxillary second molar teeth were examined in vivo by CBCT. The number of roots, the number of canals per root, the canal configuration and the presence of additional mesiobuccal canals were recorded. Vertucci's classification for root-canal configurations was utilized. All maxillary first molars had three separate roots; however, 52% of mesiobuccal (MB) roots had two canals with the remainder having one. All distobuccal and palatal roots had Vertucci Type I canal configurations. When the MB2 canal was present, 14, 69 and 16% of MB roots had Type II, IV and V canal configurations, respectively. The root canal system of the maxillary first molar teeth could be categorized into two variants: one with three separate roots with one canal in each of the distobuccal and palatal roots and two canals in the MB root, and the other with three separate roots with one canal in each root. Of 210 maxillary second molars, 10% had one root, 8% two roots and 81% three roots. Of the MB roots, 22% had two canals with the remainder having one. When the MB2 canal was present, 18%, 58%, 10% and 3% of MB roots had type II, IV, V and VI canal configurations, respectively. The root canal system of the maxillary second molar could be categorized into eight variants. Mesiobucccal roots of maxillary molar teeth had more variation in their canal system than the distobuccal or palatal roots. The root canal configuration of the maxillary second molars was more variable than that of the first molars. CBCT can enhance detection and mapping of the mesiobuccal root-canal system with the potential to improve the quality of root canal treatment.