Root Morphology and Number of Canals in Mandibular Central and Lateral Incisors Using Cone Beam Computed Tomography

Abstract

Most failures in endodontic treatment of mandibular incisors are due to the presence of a missed canal specifically the lingual. This investigation aimed to examine the root morphology and number of canals in mandibular incisors using cone beam computed tomography (CBCT). Two hundred and seven patients were assessed in terms of their mandibular central and lateral incisors of CBCT. The inclusion criteria were absence of root resorption, coronal restoration or root filling and clarity and optimal resolution of images. According to the Vertucci's classification, number of roots and canals and type of canal were evaluated by two oral and maxillofacial radiologists. In order to data analysis SPSS version 16 and descriptive statistics were implemented. All mandibular incisors had one root. Most central (84.5%) and lateral (78.2%) incisors had a single canal (p= 0.065). The majority of central (54.5%) and lateral (56.5%) incisors were Vertucci's type I (p= 0.102). Prevalence of one canal in males: central (84.8%), lateral (77.9%) and in females: central (84.2%), lateral (78.5%) (p= 0.518). Prevalence of Vertucci's type I in males: central (52.3%), lateral (45.3%) and in females: central (56.1%), lateral (64.4%) (p=0.188). The prevalence of two canals was 15.5% (central) and 21.8% (lateral) in mandibular incisors. The Vertucci's type I was the most typical kinds of mandibular incisors. Considering the limitations of periapical radiography in determining canal morphology, CBCT can be helpful in case of any concern regarding root canal morphology.

Symmetry of root and root canal morphology of mandibular incisors: A cone-beam computed tomography study in vivo

“…The study of the anatomy is very important in endodontics, since most of the errors that occur during an endodontic treatment are related to failure in respecting the canal anatomy (1); the existence of an untreated canal may be a reason of failure (2). To achieve these goals, clinical examination and diagnostic imaging are both essential elements of preoperative diagnosis and treatment planning (3).…”

Root Canal Morphology of the Permanent Mandibular Incisors by Cone Beam Computed Tomography: A Systematic Review

“…Of these, 2219 were removed because of their being duplicates or not related to the study. Of the remaining 71 studies, 52 were removed due to lack of relevance, not using CBCT as their diagnostic methodology, or being in vitro trials, case studies or systematic reviews, leaving a total of 19 studies [8,14,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] (Figure 3. Flowchart).…”

“…When there were two canals, the most frequent classification was type III, with the exception of four studies [8,22,23,35]. There was no heterogeneity as to the frequency of the rest of configurations, with studies where the next most frequent configurations were type II [14,23,26,27,30,33,34], type V [8,[19][20][21]24,25,28,29,32], or type IV [31]. The remaining types [VI, VII and others] were generally present in very low or non-existent percentages.…”

“…Five studies reported symmetry between the incisors on the right and left side of the patient [8,19,20,23,26,33]. Lateral incisors showed a higher prevalence in the existence of a second canal compared to central incisors in fourteen studies [7,14,[20][21][22]25,[27][28][29][31][32][33][34][35]. The central incisor had a higher prevalence in only three [19,23,26].…”

“…The remaining studies did not assess patient age or, if so, did not find any significant differences [8,30]. Regarding gender influence, there was no unanimity as to a higher prevalence of second canals in men [19,20,24,31] than in women [27,29], and there were even certain studies where no significant differences were found [8,22,25,30,34,35]. Geographical distribution indicated a lower incidence of a second canal in the Chinese population [14,29,[32][33][34].…”