Variations in the root canal anatomy of mandibular anterior teeth in the South Indian population
Main Article Content
Keywords
Cone beam computed tomography, Mandibular incisors, Mandibular canines, Root canal anatomy
Abstract
Aim: The objective of this study was to use CBCT to assess the variations in root canal anatomy of the mandibular central and lateral incisors and canines in the South Indian population.
Materials and methods: This retrospective CBCT study was done to investigate 1152 permanent mandibular anterior teeth (378 centrals, 384 laterals, and 390 canines) acquired from 200 CBCT images, of which 96 were males and 104 were females, with ages ranging from 20-65 years, acquired from the AxeosTM Imaging System (Dentsply Sirona). Slices of 0.2 mm thickness in the axial, sagittal and coronal planes were then selected. Galileos software (Dentsply Sirona) was used to study the images on a computer in a semi-dark room with a constant intensity of light. After this, the incisors and canine root canals were classified based on Vertucci’s classification and tabulated.
Results: Statistical analysis was done by chi square test and Mann-Whitney U test to assess the prevalence of various canal configurations. Out of 1152 assessed mandibular anterior teeth, 51.85% central incisors(193/368), 61.45% lateral incisors (236/376) and 44.10% canines had type III canal configuration. The most common canal configuration observed in mandibular central and lateral incisors was Type III, followed by Type I. On the other hand, Type I configuration was more prevalent in canines, particularly in the left mandibular canines, followed by Type III.
Conclusion: A higher number of participants had Vertucci’s type III classification, followed by type I. A higher prevalence of two canals was seen in males compared to females.
References
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27. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984 Nov;58(5):589–99.
28. Kaffe I, Kaufman A, Littner MM, Lazarson A. Radiographic study of the root canal system of mandibular anterior teeth. Int Endod J. 1985 Oct;18(4):253–9.
29. Mauger MJ, Schindler WG, Walker WA 3rd. An evaluation of canal morphology at different levels of root resection in mandibular incisors. J Endod. 1998 Sep;24(9):607–9.
30. Kaya S, Adiguzel O, Yavuz I, Tumen EC, Akkus Z. Cone-beam dental computerized tomography for evaluating changes of aging in the dimensions central superior incisor root canals. Med Oral Patol Oral Cir Bucal. 2011 May 1;16(3):e463–6.
31. Lund H, Gröndahl K, Gröndahl HG. Cone beam computed tomography for assessment of root length and marginal bone level during orthodontic treatment. Angle Orthod. 2010 May;80(3):466–73.
32. Michetti J, Maret D, Mallet JP, Diemer F. Validation of cone beam computed tomography as a tool to explore root canal anatomy. J Endod. 2010 Jul;36(7):1187–90.
33. Sangar S, Vadivel JK. Awareness of dental students towards CBCT: A cross sectional study. Journal of Indian Academy of Oral Medicine and Radiology. 2020;32(4):366.
34. Janani K, Sandhya R. A survey on skills for cone beam computed tomography interpretation among endodontists for endodontic treatment procedure. Indian J Dent Res. 2019 Nov-Dec;30(6):834–8.
35. Rajakeerthi R, Nivedhitha MSB. Use of cone beam computed tomography to identify the morphology of maxillary and mandibular premolars in Chennai population. Braz Dent Sci. 2019 Jan 31;22(1):55–62.
36. Patel S. New dimensions in endodontic imaging: Part 2. Cone beam computed tomography. Int Endod J. 2009 Jun;42(6):463–75.
37. Jerry Jose, Ajitha P. Evaluation of Root Canal Morphology of Lower Lateral Incisors using Cone Beam Computed Tomography in an Indian Subpopulation. Int J Dentistry Oral Sci. 2020;7(12):1193-1196.
38. Nivedhitha, Nivedhitha. (2021). Retrospective CBCT Analysis Of Root Canal Morphology Of Mandibular Incisors In Indian Sub Population. International Journal of Dentistry and Oral Science. 2591-2596. 10.19070/2377-8075-21000507.
39. Mirhosseini F, Tabrizizadeh M, Nateghi N, Shafiei Rad E, Derafshi A, Ahmadi B, et al. Evaluation of Root Canal Anatomy in Mandibular Incisors Using CBCT Imaging Technique in an Iranian Population. J Dent. 2019 Mar;20(1):24–9.
40. Karobari MI, Noorani TY, Halim MS, Ahmed HMA. Root and canal morphology of the anterior permanent dentition in Malaysian population using two classification systems: A CBCT clinical study. Aust Endod J. 2021 Aug;47(2):202–16.
41. Haghanifar S, Moudi E, Bijani A, Ghanbarabadi MK. Morphologic assessment of mandibular anterior teeth root canal using CBCT. Acta Med Acad. 2017 Nov;46(2):85–93.
42. Boruah LC, Bhuyan AC. Morphologic characteristics of root canal of mandibular incisors in North-East Indian population: An in vitro study. J Conserv Dent. 2011 Oct;14(4):346–50.
43. Geduk G, Deniz Y, Zengin AZ, Eroglu E. Cone-beam computed tomography study of root canal morphology of permanent mandibular incisors in a Turkish sub-population. Journal of Oral and Maxillofacial Radiology. 2015 Jan 1;3(1):7.
44. Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod. 2004 Jun;30(6):391–8.
45. Jaju PP, Jaju SP. Clinical utility of dental cone-beam computed tomography: current perspectives. Clin Cosmet Investig Dent. 2014 Apr 2;6:29–43.
46. Iqbal A, Karobari MI, Alam MK, Khattak O, Alshammari SM, Adil AH, et al. Evaluation of root canal morphology in permanent maxillary and mandibular anterior teeth in Saudi subpopulation using two classification systems: a CBCT study. BMC Oral Health. 2022 May 10;22(1):171.
47. Saber SEDM, Ahmed MHM, Obeid M, Ahmed HMA. Root and canal morphology of maxillary premolar teeth in an Egyptian subpopulation using two classification systems: a cone beam computed tomography study. Int Endod J. 2019 Mar;52(3):267–78.
2. Iffat Nasim, Srujana Hemmanur. Knowledge, Attitude, and Practice Survey On The Choice Of Local Anesthetic Solution and Methods Used To Anesthetize Dental Pulp By General Dental Practitioners. Int J Dentistry Oral Sci. 2021;08(05):2620-2625.
3. Siqueira JF Jr. Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 2001 Jan;34(1):1–10.
4. Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: systematic review of the literature - part 1. Effects of study characteristics on probability of success. Int Endod J. 2007 Dec;40(12):921–39.
5. Patil, Santosh & Maragathavalli, Gopal & Araki, Kazuyuki & Al-Zoubi, Ibrahim & Sghaireen, Mohammed & Gudipaneni, Ravi & Alam, Mohammad. (2018). Three-Rooted Mandibular First Molars in a Saudi Arabian Population: A CBCT Study. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 18. e4133. 10.4034/PBOCI.2018.181.87.
6. Jitesh S, Adimulapu Hima Sandeep, Madhulaxmi M. Number of Calcified Maxillary Anteriors Undergoing Root Canal Treatment Under 50 Years of Age - an Institutional Study. Int J Dentistry Oral Sci. 2021;8(8):3981-3984
7. Cantatore G, Berutti E, Castellucci A. Missed anatomy: frequency and clinical impact. Endod Topics. 2006 Nov;15(1):3–31.
8. Manish Ranjan, Srujana Hemmanur. Endodontic Management Of Maxillary Molars With Aberrant Anatomy - A Case Series. Int J Dentistry Oral Sci. 2021;08(05):2653-2658
9. Iqbal A. The Factors Responsible for Endodontic Treatment Failure in the Permanent Dentitions of the Patients Reported to the College of Dentistry, the University of Aljouf, Kingdom of Saudi Arabia. J Clin Diagn Res. 2016 May;10(5):ZC146–8.
10. Weng XL, Yu SB, Zhao SL, Wang HG, Mu T, Tang RY, et al. Root canal morphology of permanent maxillary teeth in the Han nationality in Chinese Guanzhong area: a new modified root canal staining technique. J Endod. 2009 May;35(5):651–6.
11. Neelakantan P, Subbarao C, Ahuja R, Subbarao CV, Gutmann JL. Cone-beam computed tomography study of root and canal morphology of maxillary first and second molars in an Indian population. J Endod. 2010 Oct;36(10):1622–7.
12. Al-Qudah AA, Awawdeh LA. Root canal morphology of mandibular incisors in a Jordanian population. Int Endod J. 2006 Nov;39(11):873–7.
13. Lin Z, Hu Q, Wang T, Ge J, Liu S, Zhu M, et al. Use of CBCT to investigate the root canal morphology of mandibular incisors. Surg Radiol Anat. 2014 Nov;36(9):877–82.
14. Kabak YS, Abbott PV. Endodontic treatment of mandibular incisors with two root canals: report of two cases. Aust Endod J. 2007 Apr;33(1):27–31.
15. Miyashita M, Kasahara E, Yasuda E, Yamamoto A, Sekizawa T. Root canal system of the mandibular incisor. J Endod. 1997 Aug;23(8):479–84.
16. Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Topics. 2005 Mar;10(1):3–29.
17. Yu DC, Tam A, Schilder H. Root canal anatomy illustrated by microcomputed tomography and clinical cases. Gen Dent. 2006 Sep-Oct;54(5):331–5.
18. Ingle JI, Bakland LK, Baumgartner JC. Ingle’s endodontics 6. Hamilton, ON, Maidenhead: BC Decker ; McGraw-Hill Education [distributor; 2008.
19. Torabinejad M, Walton RE. Endodontics: Principles and Practice. Elsevier Health Sciences; 2009. 474 p.
20. Reuben J, Velmurugan N, Kandaswamy D. The evaluation of root canal morphology of the mandibular first molar in an Indian population using spiral computed tomography scan: an in vitro study. J Endod. 2008 Feb;34(2):212–5.
21. Cleghorn BM, Christie WH, Dong CCS. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod. 2006 Sep;32(9):813–21.
22. Alaçam T, Tinaz AC, Genç O, Kayaoglu G. Second mesiobuccal canal detection in maxillary first molars using microscopy and ultrasonics. Aust Endod J. 2008 Dec;34(3):106–9.
23. Cotton TP, Geisler TM, Holden DT, Schwartz SA, Schindler WG. Endodontic applications of cone-beam volumetric tomography. J Endod. 2007 Sep;33(9):1121–32.
24. Scarfe WC, Ag F. White and Pharoah Oral Radiology Principles and Interpretation. China: Elsevier; 2014.
25. Joy R, Kannan A, Lakshmi KC, Lakshminrusimhan DKS, Roy A. Comparison of Cone Beam Computed Tomography Performance at Different Voxel Sizes in the Evaluation of Mandibular Canal – An In vitro Study. Journal of Indian Academy of Oral Medicine and Radiology. 2022;34(3):309.
26. Special Committee to Revise the Joint AAE/AAOMR Position Statement on use of CBCT in Endodontics. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Oct;120(4):508–12.
27. Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984 Nov;58(5):589–99.
28. Kaffe I, Kaufman A, Littner MM, Lazarson A. Radiographic study of the root canal system of mandibular anterior teeth. Int Endod J. 1985 Oct;18(4):253–9.
29. Mauger MJ, Schindler WG, Walker WA 3rd. An evaluation of canal morphology at different levels of root resection in mandibular incisors. J Endod. 1998 Sep;24(9):607–9.
30. Kaya S, Adiguzel O, Yavuz I, Tumen EC, Akkus Z. Cone-beam dental computerized tomography for evaluating changes of aging in the dimensions central superior incisor root canals. Med Oral Patol Oral Cir Bucal. 2011 May 1;16(3):e463–6.
31. Lund H, Gröndahl K, Gröndahl HG. Cone beam computed tomography for assessment of root length and marginal bone level during orthodontic treatment. Angle Orthod. 2010 May;80(3):466–73.
32. Michetti J, Maret D, Mallet JP, Diemer F. Validation of cone beam computed tomography as a tool to explore root canal anatomy. J Endod. 2010 Jul;36(7):1187–90.
33. Sangar S, Vadivel JK. Awareness of dental students towards CBCT: A cross sectional study. Journal of Indian Academy of Oral Medicine and Radiology. 2020;32(4):366.
34. Janani K, Sandhya R. A survey on skills for cone beam computed tomography interpretation among endodontists for endodontic treatment procedure. Indian J Dent Res. 2019 Nov-Dec;30(6):834–8.
35. Rajakeerthi R, Nivedhitha MSB. Use of cone beam computed tomography to identify the morphology of maxillary and mandibular premolars in Chennai population. Braz Dent Sci. 2019 Jan 31;22(1):55–62.
36. Patel S. New dimensions in endodontic imaging: Part 2. Cone beam computed tomography. Int Endod J. 2009 Jun;42(6):463–75.
37. Jerry Jose, Ajitha P. Evaluation of Root Canal Morphology of Lower Lateral Incisors using Cone Beam Computed Tomography in an Indian Subpopulation. Int J Dentistry Oral Sci. 2020;7(12):1193-1196.
38. Nivedhitha, Nivedhitha. (2021). Retrospective CBCT Analysis Of Root Canal Morphology Of Mandibular Incisors In Indian Sub Population. International Journal of Dentistry and Oral Science. 2591-2596. 10.19070/2377-8075-21000507.
39. Mirhosseini F, Tabrizizadeh M, Nateghi N, Shafiei Rad E, Derafshi A, Ahmadi B, et al. Evaluation of Root Canal Anatomy in Mandibular Incisors Using CBCT Imaging Technique in an Iranian Population. J Dent. 2019 Mar;20(1):24–9.
40. Karobari MI, Noorani TY, Halim MS, Ahmed HMA. Root and canal morphology of the anterior permanent dentition in Malaysian population using two classification systems: A CBCT clinical study. Aust Endod J. 2021 Aug;47(2):202–16.
41. Haghanifar S, Moudi E, Bijani A, Ghanbarabadi MK. Morphologic assessment of mandibular anterior teeth root canal using CBCT. Acta Med Acad. 2017 Nov;46(2):85–93.
42. Boruah LC, Bhuyan AC. Morphologic characteristics of root canal of mandibular incisors in North-East Indian population: An in vitro study. J Conserv Dent. 2011 Oct;14(4):346–50.
43. Geduk G, Deniz Y, Zengin AZ, Eroglu E. Cone-beam computed tomography study of root canal morphology of permanent mandibular incisors in a Turkish sub-population. Journal of Oral and Maxillofacial Radiology. 2015 Jan 1;3(1):7.
44. Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod. 2004 Jun;30(6):391–8.
45. Jaju PP, Jaju SP. Clinical utility of dental cone-beam computed tomography: current perspectives. Clin Cosmet Investig Dent. 2014 Apr 2;6:29–43.
46. Iqbal A, Karobari MI, Alam MK, Khattak O, Alshammari SM, Adil AH, et al. Evaluation of root canal morphology in permanent maxillary and mandibular anterior teeth in Saudi subpopulation using two classification systems: a CBCT study. BMC Oral Health. 2022 May 10;22(1):171.
47. Saber SEDM, Ahmed MHM, Obeid M, Ahmed HMA. Root and canal morphology of maxillary premolar teeth in an Egyptian subpopulation using two classification systems: a cone beam computed tomography study. Int Endod J. 2019 Mar;52(3):267–78.
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Jun 6, 2023
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Astha Bramhecha, Manish Ranjan, & Srujana Hemmanur. (2023). Variations in the root canal anatomy of mandibular anterior teeth in the South Indian population. Journal of Population Therapeutics and Clinical Pharmacology, 30(14), 159–167. https://doi.org/10.47750/jptcp.2023.30.14.021
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