Cone beam computed tomography evaluation of c-shaped canal morphology in mandibular premolar teeth

Year 2024, Volume: 58 Issue: 2, 70 - 75, 08.05.2024

Elif Aslan , Ali Canberk Ulusoy , B. Güniz Baksı , Ali Mert , Bilge Hakan Şen

https://doi.org/10.26650/eor.20241175997

Abstract

Purpose: The aim of this study was to evaluate the prevalence and the morphology of c-shaped root canal(s) in mandibular premolars using cone beam computed tomography (CBCT) images.
Materials and Methods: CBCT images of 1095 mandibular premolars were examined at coronal, middle, and apical levels of the root canals. The type, the level, and the position (buccal or lingual) of the c-shaped anatomy were recorded. Absolute counts and percentages of different groups and subgroups of C-shape morphologies were calculated. The Chi-square test was used to compare the prevalence of C-shaped morphology between mandibular first and second premolars. The Z-test for proportions in independent groups was used to analyze the differences in mandibular C-shaped premolar proportions between location (left and right side) and tooth (first or second premolars) (p=0.05).
Results: c-shaped root canal morphology was present in 44 teeth. The percentage of c-shaped morphologies was 6.9% and 1.6% in mandibular first and second premolars, respectively. Comparison of the first and the second premolars showed that C1 type (p=0.008) and C4b type (p=0.013) configurations are more common in the first premolars at the coronal level. In contrast, the C2 type configuration showed significantly higher prevalence in the second premolars (p=0.009). Additionally, the C4c type configuration was significantly frequent on the right premolars at the coronal level (p=0.038).
Conclusions: C-shape canal morphology is a rare but complex anatomic feature in mandibular premolars. Therefore, clinicians should be aware of this complex root canal anatomy for the success of endodontic treatment in mandibular premolar teeth.

Keywords

C-shaped configuration, cone beam computed tomography, mandibular premolar, prevalence study, root canal anatomy

Mandibular premolar dişlerde c-şekilli kanal morfolojisinin konik ışınlı-bt ile değerlendirmesi

Abstract

Amaç: Bu çalışmanın amacı, mandibular premolar dişlerdeki C-şekilli kök kanal(lar)ının prevalansının ve morfolojisinin konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleri kullanılarak değerlendirmesidir.
Gereç ve Yöntem: 1095 mandibular premolar dişe ait KIBT görüntüsü koronal, orta ve apikal kök seviyelerinde incelenerek C-şekilli anatominin tipi, seviyesi ve pozisyonu (bukkal veya lingual) kaydedildi. Farklı gruplara ve altgruplara göre C-şekilli morfolojinin dağılımı ve yüzdesi hesaplandı. Mandibular birinci ve ikinci premolar dişler arasında C-şekilli morfolojinin prevalansının karşılaştırılması amacıyla Ki-kare testi kullanıldı. Farklı konum (sol ve sağ) ve diş grupları (birinci ve ikinci premolar dişler) arasındaki C-şekilli morfoloji farklılıklarının analiz edilmesi amacıyla ise Z-testi kullanıldı (p=0,05).
Bulgular: 44 mandibular premolar dişte C-şekilli kök kanal morfolojisi saptandı. Mandibular birinci ve ikinci premolar dişlerdeki C-şekilli morfolojilerin yüzdesi sırasıyla %6,9 ve %1,6 olarak hesaplandı. Birinci ve ikinci premolar dişlerin karşılaştırılması sonucu, birinci premolar dişlerin koronal seviyesinde C1 tipi (p=0,008) ve C4b tipi (p=0,013) konfigürasyonların daha yaygın olduğunu belirlendi. Buna karşılık, ikinci premolar dişlerde ise C2 tipi konfigürasyonun anlamlı olarak yaygın olduğu gözlendi (p=0,009). Ek olarak, sağ premolar dişlerin koronal seviyesinde C4c tipi konfigürasyonun anlamlı derecede sık görüldüğü saptandı (p=0,038).
Sonuç: C-şekilli kanal morfolojisi, mandibular premolar dişlerde nadir olarak izlenen karmaşık bir anatomik varyasyondur. Klinisyenlerin mandibular premolar dişlerde görülen bu karmaşık kök kanal anatomisi hakkında farkındalık sahibi olması, endodontik tedavinin başarısı açısından önem taşımaktadır.

Keywords

C-şekilli kanal morfolojisi, konik ışınlı bilgisayarlı tomografi, kök kanal anatomisi, mandibular premolar, prevalans çalışması

References

• Fan B, Yang J, Gutmann JL, Fan M. Root canal systems in mandibular first premolars with C-shaped root configurations. Part I: Microcomputed tomography mapping of the radicular groove and associated root canal cross-sections. J Endod 2008;34:1337-41. google scholar
• Jafarzadeh H, Wu YN. The C-shaped root canal configuration: a review. J Endod 2007;33:517-23. google scholar
• Martins JNR, Marques D, Silva EJNL, Caramês J, Mata A, Versiani MA. Prevalence of C-shaped canal morphology using cone beam computed tomography - a systematic review with meta-analysis. Int Endod J 2019;52:1556-72. google scholar
• Helvacioglu-Yigit D, Sinanoglu A. Use of cone-beam computed tomography to evaluate C-shaped root canal systems in mandibular second molars in a Turkish subpopulation: a retrospective study. Int Endod J 2013;46:1032-8. google scholar
• Fan B, Cheung GS, Fan M, Gutmann JL, Bian Z. C-shaped canal system in mandibular second molars: Part I--Anatomical features. J Endod 2004;30:899-903. google scholar
• Cooke HG 3rd, Cox FL. C-shaped canal configurations in mandibular molars. J Am Dent Assoc 1979;99:836–9. google scholar
• Lu TY, Yang SF, Pai SF. Complicated root canal morphology of mandibular first premolar in a Chinese population using the cross section method. J Endod 2006;32:932-6. google scholar
• Fernandes M, de Ataide I, Wagle R. C-shaped root canal configuration: A review of literature. J Conserv Dent 2014;17:312-9. google scholar
• Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Topics 2005;10:3–29. google scholar
• Wu MK, R'oris A, Barkis D, Wesselink PR. Prevalence and extent of long oval canals in the apical third. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:739-43. google scholar
• Patel S, Patel R, Foschi F, Mannocci F. The Impact of Different Diagnostic Imaging Modalities on the Evaluation of Root Canal Anatomy and Endodontic Residents' Stress Levels: A Clinical Study. J Endod 2019;45:406-13. google scholar
• 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;120:508-12. google scholar
• Alfawaz H, Alqedairi A, Alkhayyal AK, et al. Prevalence of C-shaped canal system in mandibular first and second molars in a Saudi population assessed via cone beam computed tomography: a retrospective study. Clin Oral Investig 2019;23:107–12. google scholar
• Kim HS, Jung D, Lee H, Han YS, Oh S, Sim HY. C-shaped root canals of mandibular second molars in a Korean population: a CBCT analysis. Restor Dent Endod 2018;2018;43:e42. google scholar
• Rahimi S, Shahi S, Lotfi M, Zand V, Abdolrahimi M, Es'haghi R. Root canal configuration and the prevalence of C-shaped canals in mandibular second molars in an Iranian population. J Oral Sci 2008;50:9-13. google scholar
• Shemesh A, Levin A, Katzenell V, et al. C-shaped canals-prevalence and root canal configuration by cone beam computed tomography evaluation in first and second mandibular molars-a cross-sectional study. Clin Oral Investig 2017;21:2039-44. google scholar
• von Zuben M, Martins JNR, Berti L, et al. Worldwide Prevalence of Mandibular Second Molar C-Shaped Morphologies Evaluated by Cone-Beam Computed Tomography. J Endod 2017;43:1442-7. google scholar
• Yang SE, Lee TY, Kim KJ. Prevalence and Morphology of C-Shaped Canals: A CBCT Analysis in a Korean Population. Scanning 2021;2021:9152004. google scholar
• Zhang X, Xiong S, Ma Y, et al. A cone-beam computed tomographic study on mandibular first molars in a Chinese subpopulation. PLoS One 2015;10:e0134919. google scholar
• Arayasantiparb R, Banomyong D. Prevalence and morphology of multiple roots, root canals and C-shaped canals in mandibular premolars from cone-beam computed tomography images in a Thai population. J Dent Sci 2021;16:201–7. google scholar
• Chaintiou Piorno R, Consoli Lizzi EP, Gualtieri AF, Rodríguez PA. C-Shaped canal system in mandibular premolars evaluated by cone-beam computed tomography in a population of the Autonomous City of Buenos Aires, Argentina. Arch Oral Biol 2021;123:105040. google scholar
• Jang YE, Kim Y, Kim B, Kim SY, Kim HJ. Frequency of non-single canals in mandibular premolars and correlations with other anatomical variants: an in vivo cone beam computed tomography study. BMC Oral Health 2019;19:272. google scholar
• Srivastava S, Gaikwad RN, Alsalhi N, Alrogaibah NA. Cone-beam Computed Tomographic Analysis of C-shaped canals and Radicular Grooves in Mandibular Premolars: Prevalence and Related Factors. J Contemp Dent Pract 2019;20:1350-4. google scholar
• Kaya Büyükbayram I, Sübay RK, Çolakoğlu G, Elçin MA, Ordulu Sübay M. Investigation using cone beam computed tomography analysis, of radicular grooves and canal configurations of mandibular premolars in a Turkish subpopulation. Arch Oral Biol 2019;107:104517. google scholar
• Pedemonte E, Cabrera C, Torres A, et al. Root and canal morphology of mandibular premolars using cone-beam computed tomography in a Chilean and Belgian subpopulation: a cross-sectional study. Oral Radiol 2018;34:143-50. google scholar
• Hajihassani N, Roohi N, Madadi K, Bakhshi M, Tofangchiha M. Evaluation of root canal morphology of mandibular first and second premolars using cone beam computed tomography in a defined group of dental patients in Iran. Scientifica (Cairo) 2017;2017:1-7. google scholar
• Mashyakhy MH, Chourasia HR, Jabali AH, et al. C-shaped canal configuration in mandibular premolars and molars: Prevalence, correlation, and differences: An In Vivo study using cone-beam computed tomography. Niger J Clin Pract 2020;23:232-9. google scholar
• Martins JNR, Francisco H, Ordinola-Zapata R. Prevalence of C-shaped Configurations in the Mandibular First and Second Premolars: A Cone-beam Computed Tomographic In Vivo Study. J Endod 2017;43:890-5. google scholar
• Aricioğlu B, Tomrukçu DN, Köse TE. Taurodontism and C-shaped anatomy: is there an association? Oral Radiol 2021;37:443–51. google scholar
• Brea G, Gomez F, Gomez-Sosa JF. Cone-beam computed tomography evaluation of C-shaped root and canal morphology of mandibular premolars. BMC Oral Health 2021;21:236. google scholar
• Yu X, Guo B, Li KZ, et al. Cone-beam computed tomography study of root and canal morphology of mandibular premolars in a western Chinese population. BMC Med Imaging 2012;12:18. google scholar
• Gu YC, Zhang YP, Liao ZG, Fei XD. A micro-computed tomographic analysis of wall thickness of C-shaped canals in mandibular first premolars. J Endod 2013;39:973-6. google scholar