Morphology of Maxillary First Molars Analyzed by Cone-Beam Computed Tomography among Malaysian: Variations in the Number of Roots and Canals and the Incidence of Fusion

Abstract

Introduction: A few studies investigated the numerous potential endodontic uses of CBCT, including the examination of root canal morphology and presumed that CBCT was effective for the initial identification of such morphology; moreover CBCT is a reliable method for the detection of the MB2 canal when compared with the gold standard of physical sectioning of the specimen. The aim of this study was to identify the root and canal morphology of the maxillary first molars among Malaysians analysed by cone-beam computed tomography (CBCT) images. Materials and Methods: Maxillary first (n = 421) molars from Malaysian patients (n = 241) of Malay, Chinese and Indians inceptions were examined by two Endodontists using in vivo CBCT methods. The number and configuration of roots, the number of root canals, and the canal configuration according to Vertucci’s classification were determined. Results: Single roots were not found in maxillary first molars. The incidence of fused roots was 1.995% in the first molars between mesiobuccal and distobuccal roots. In (421) 3-rooted maxillary first molars, additional canals were found in 45.6% of the mesiobuccal (MB) roots and 0% of the distobuccal (DB) roots. Bilateral symmetry of the MB roots was found in 82.36% of the first molar. Only one tooth was found to have pulp stone inside the pulp chamber. Conclusions: The root and canal configuration of a Malaysian population showed different features from those of other populations. CBCT scans can enhance the understanding of root canal anatomy, with the potential of improving the outcome of endodontic treatment.

Analysis of root and canal morphology of maxillaryfirst and second molars among malay ethnic in the malaysian population with the aid of cone-beam computed tomography: A retrospective study

“…[2,6] Using similar imaging methods, Al-Kadhim et al reported that 98% of maxillary first molars have three separate roots, which is almost identical to our finding (97.7%). [21] Our result is also consistent with a study from our neighboring country, Thailand, which found that 99.8% of first molars and 87.1% of second molars have three roots. [6] However, we found a slight anatomical variation of maxillary first and second molars in Malay ethnic.…”

“…[14][15][16][17][18][19][20] Recently, more studies have been utilizing CBCT as a method to study root and canal morphology. [6,[21][22][23][24][25][26][27][28][29][30][31] CBCT imaging is more accurate, effective, and reliable as a diagnostic tool compared to other imaging modalities and conventional methods. [23,32] For clinical settings, the American Association of Endodontics and American Academy of Oral and Maxillofacial Radiology recently came up with a comprehensive guideline regarding the use of CBCT imaging in endodontics for the initial assessment of teeth with suspected additional canals and second molars than females.…”

“…However, there have been inconsistent findings on the correlation between gender and prevalence of MB2 canal in maxillary molars in other studies. [4,6,21,26,28,29,31] Therefore, a definite relationship between these two variables has yet to be confirmed and established.…”

“…Our prevalence of MB2 canal in the first molars was slightly higher than Al-Kadhim et al(45.6%). [21] This difference could be due to our inclusion criteria of only Malay ethnic, instead of including Chinese and Indians ethnic. Hence, our finding was descriptive of a single ethnic, instead of the general population.…”

Root and canal morphology of the anterior permanent dentition in Malaysian population using two classification systems: A CBCT clinical study

“…Limited information is available on the root and canal morphology in the Malaysian population using CBCT (20,21). This CBCT study aimed to evaluate the root and root canal morphology of permanent anterior dentition in relation to ethnicity, gender and age of patients in a Malaysian population using two classification systems.…”