Imaging Sci Dent.  2021 Dec;51(4):383-388. 10.5624/isd.20210038.

Evaluation of mesial root canal configuration of mandibular first molars using micro-computed tomography

Affiliations
  • 1Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Beykent University, Istanbul, Turkey
  • 2Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Gelişim University, Istanbul, Turkey

Abstract

Purpose
The aim of this study was to evaluate the root canal morphology of mesial roots of mandibular first molars.
Materials and Methods
Forty extracted mandibular first molars were used in this study. The morphological examination of root canals was conducted in accordance with the Vertucci classification using micro-computed tomography (micro-CT). Any aberrant root canal configurations not included in the Vertucci classification were recorded, and their frequency was established using descriptive statistics. Intra-observer reliability was assessed using the Wilcoxon signed-rank test, while inter-observer reliability was assessed using the Cohen kappa test. Significance was evaluated at the P<0.05 level.
Results
The mesial roots of mandibular first molars had canal configurations of type I (15%), type II (7.5%), type III (25%), type IV (10%), type V (2.5%), type VI (7.5%), and type VII (7.5%). The images showed 10 (25%) additional configuration types that were not included in the Vertucci classification. These types were 1-3-2-3, 1-2-3-2-3, 2-3-1, 2-3, 1-2-3-1, 2-1-2-3, 3-2-1, 1-2-3-1, 2-3-2-3, and 1-2-1-2-1. The intra-observer differences were not statistically significant (P>0.05) and the kappa value for inter-observer agreement was found to be 0.957.
Conclusion
Frequent variations were detected in mesial roots of mandibular first molars. Clinicians should take into consideration the complex structure of the root canal morphology before commencing root canal treatment procedures to prevent iatrogenic complications. Micro-CT was a highly suitable method to provide accurate 3-dimensional visualizations of root canal morphology.

Keyword

Anatomy; Dental Pulp Cavity; X-Ray Microtomography; Dentition; Permanent
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