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Complicated Root Canal Configuration of Mandibular First Premolars Is Correlated with the Presence of the Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in Taiwanese Individuals

Published:April 14, 2017DOI:https://doi.org/10.1016/j.joen.2017.01.027

      Abstract

      Introduction

      The purpose of this study was to examine the frequency and bilateral consistency of distolingual roots (DLRs) in permanent mandibular first molars (PMFMs) and root canal configurations in PMFPs (permanent mandibular first premolars) and to determine the correlation between the root canal configurations of PMFPs with the appearance of DLRs in PMFMs.

      Methods

      A total of 932 cone-beam computed tomographic images of PMFMs and PMFPs were collected from 233 patients. The frequency and bilateral consistency of DLRs in PMFMs along with root canal configurations (root number and canal number) of PMFPs were recorded and evaluated ipsilaterally and contralaterally. Multivariable logistic regression analysis was used to evaluate the correlation between the root canal configurations of PMFPs with the appearance of DLRs in PMFMs.

      Results

      The prevalence of PMFMs with DLRs was 24.7%, and the incidence of complicated root canal configurations of PMFPs was 26.6%. The incidence of complicated root canal configurations of PMFPs was 19.6% in the non-DLR group, 37.2% in the unilateral DLR group, and 44.7% in the bilateral DLR group. After adjusting for categoric variables including sex, age, and side, the odds ratios for the frequency of complicated root canal configurations of PMFPs in the unilateral DLR and bilateral DLR groups compared with the non-DLR group were 2.472 (95% confidence interval, 1.434–4.263; P = .001) and 3.392 (95% confidence interval, 1.976–5.823; P < .001), respectively.

      Conclusions

      An increasing and corresponding trend between the presence of DLRs in PMFMs and complicated root canal configurations in PMFPs was noted in Taiwanese individuals. These results suggest that the clinicians should familiarize themselves with the anatomic variants of PMFMs and PMFPs before endodontic treatment.

      Key Words

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      References

        • Vizzotto M.B.
        • Silveira P.F.
        • Arus N.A.
        • et al.
        CBCT for the assessment of second mesiobuccal (MB2) canals in maxillary molar teeth: effect of voxel size and presence of root filling.
        Int Endod J. 2013; 46: 870-876
        • Cleghorn B.M.
        • Christie W.H.
        • Dong C.C.
        The root and root canal morphology of the human mandibular first premolar: a literature review.
        J Endod. 2007; 33: 509-516
        • Tabassum S.
        • Khan F.R.
        Failure of endodontic treatment: The usual suspects.
        Eur J Dent. 2016; 10: 144-147
        • Ballullaya S.V.
        • Vemuri S.
        • Kumar P.R.
        Variable permanent mandibular first molar: review of literature.
        J Conserv Dent. 2013; 16: 99-110
        • Yousuf W.
        • Khan M.
        • Mehdi H.
        Endodontic procedural errors: frequency, type of error, and the most frequently treated tooth.
        Int J Dent. 2015; 2015: 673914
        • Jafarzadeh H.
        • Azarpazhooh A.
        • Mayhall J.T.
        Taurodontism: a review of the condition and endodontic treatment challenges.
        Int Endod J. 2008; 41: 375-388
        • Fernandes M.
        • de Ataide I.
        • Wagle R.
        C-shaped root canal configuration: a review of literature.
        J Conserv Dent. 2014; 17: 312-319
        • Tu M.G.
        • Tsai C.C.
        • Jou M.J.
        • et al.
        Prevalence of three-rooted mandibular first molars among Taiwanese individuals.
        J Endod. 2007; 33: 1163-1166
        • Tu M.G.
        • Huang H.L.
        • Hsue S.S.
        • et al.
        Detection of permanent three-rooted mandibular first molars by cone-beam computed tomography imaging in Taiwanese individuals.
        J Endod. 2009; 35: 503-507
        • Huang R.Y.
        • Cheng W.C.
        • Chen C.J.
        • et al.
        Three-dimensional analysis of the root morphology of mandibular first molars with distolingual roots.
        Int Endod J. 2010; 43: 478-484
        • Huang R.Y.
        • Lin C.D.
        • Lee M.S.
        • et al.
        Mandibular disto-lingual root: a consideration in periodontal therapy.
        J Periodontol. 2007; 78: 1485-1490
        • Kim K.R.
        • Song J.S.
        • Kim S.O.
        • et al.
        Morphological changes in the crown of mandibular molars with an additional distolingual root.
        Arch Oral Biol. 2013; 58: 248-253
        • Kim S.Y.
        • Yang S.E.
        Cone-beam computed tomography study of incidence of distolingual root and distance from distolingual canal to buccal cortical bone of mandibular first molars in a Korean population.
        J Endod. 2012; 38: 301-304
        • Ingle J.
        • Glick D.
        The Washington study.
        in: Ingle J. Endodontics. 1st ed. Lea & Febiger, Philadelphia1965: 54-77
        • Betancourt P.
        • Navarro P.
        • Cantin M.
        • Fuentes R.
        Cone-beam computed tomography study of prevalence and location of MB2 canal in the mesiobuccal root of the maxillary second molar.
        Int J Clin Exp Med. 2015; 8: 9128-9134
        • Yang H.
        • Tian C.
        • Li G.
        • et al.
        A cone-beam computed tomography study of the root canal morphology of mandibular first premolars and the location of root canal orifices and apical foramina in a Chinese subpopulation.
        J Endod. 2013; 39: 435-438
        • Sung C.E.
        • Cochran D.L.
        • Cheng W.C.
        • et al.
        Preoperative assessment of labial bone perforation for virtual immediate implant surgery in the maxillary esthetic zone: a computer simulation study.
        J Am Dent Assoc. 2015; 146: 808-819
        • Tian X.M.
        • Yang X.W.
        • Qian L.
        • et al.
        Analysis of the root and canal morphologies in maxillary first and second molars in a chinese population using cone-beam computed tomography.
        J Endod. 2016; 42: 696-701
        • Lu T.Y.
        • Yang S.F.
        • Pai S.F.
        Complicated root canal morphology of mandibular first premolar in a Chinese population using the cross section method.
        J Endod. 2006; 32: 932-936
        • Landis J.R.
        • Koch G.G.
        An application of hierarchical kappa-type statistics in the assessment of majority agreement among multiple observers.
        Biometrics. 1977; 33: 363-374
        • Huang Y.D.
        • Wu J.
        • Sheu R.J.
        • et al.
        Evaluation of the root and root canal systems of mandibular first premolars in northern Taiwanese patients using cone-beam computed tomography.
        J Formos Med Assoc. 2015; 114: 1129-1134
        • Chen G.
        • Yao H.
        • Tong C.
        Investigation of the root canal configuration of mandibular first molars in a Taiwan Chinese population.
        Int Endod J. 2009; 42: 1044-1049
        • Chen Y.C.
        • Lee Y.Y.
        • Pai S.F.
        • Yang S.F.
        The morphologic characteristics of the distolingual roots of mandibular first molars in a Taiwanese population.
        J Endod. 2009; 35: 643-645
        • Rodriguez-Niklitschek C.A.
        • Oporto G.H.
        • Garay I.
        • Salazar L.A.
        Clinical, imaging and genetic analysis of double bilateral radix entomolaris.
        Folia Morphol (Warsz). 2015; 74: 127-132
        • Schafer E.
        • Breuer D.
        • Janzen S.
        The prevalence of three-rooted mandibular permanent first molars in a German population.
        J Endod. 2009; 35: 202-205
        • Sperber G.H.
        • Moreau J.L.
        Study of the number of roots and canals in Senegalese first permanent mandibular molars.
        Int Endod J. 1998; 31: 117-122
        • Song J.S.
        • Kim S.O.
        • Choi B.J.
        • et al.
        Incidence and relationship of an additional root in the mandibular first permanent molar and primary molars.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107: e56-e60
        • Steelman R.
        Incidence of an accessory distal root on mandibular first permanent molars in Hispanic children.
        ASDC J Dent Child. 1986; 53: 122-123
        • Loh H.S.
        Incidence and features of three-rooted permanent mandibular molars.
        Aust Dent J. 1990; 35: 434-437
        • Curzon M.E.
        Three-rooted mandibular permanent molars in English caucasians.
        J Dent Res. 1973; 52: 181
        • Mu Y.D.
        • Xu Z.
        • Contreras C.I.
        • et al.
        Mutational analysis of AXIN2, MSX1, and PAX9 in two Mexican oligodontia families.
        Genet Mol Res. 2013; 12: 4446-4458
        • Kottoor J.
        • Albuquerque D.
        • Velmurugan N.
        • Kuruvilla J.
        Root anatomy and root canal configuration of human permanent mandibular premolars: a systematic review.
        Anat Res Int. 2013; 2013: 254250
        • Park J.B.
        • Kim N.
        • Park S.
        • et al.
        Evaluation of root anatomy of permanent mandibular premolars and molars in a Korean population with cone-beam computed tomography.
        Eur J Dent. 2013; 7: 94-101
        • Liu N.
        • Li X.
        • Liu N.
        • et al.
        A micro-computed tomography study of the root canal morphology of the mandibular first premolar in a population from southwestern China.
        Clin Oral Investig. 2013; 17: 999-1007
        • Akbar I.
        Radiographic study of the problems and failures of endodontic treatment.
        Int J Health Sci (Qassim). 2015; 9: 111-118
        • Counihan K.P.
        • O'Connell A.C.
        Case report: pre-eruptive intra-coronal radiolucencies revisited.
        Eur Arch Paediatr Dent. 2012; 13: 221-226
        • Tsesis I.
        • Steinbock N.
        • Rosenberg E.
        • Kaufman A.Y.
        Endodontic treatment of developmental anomalies in posterior teeth: treatment of geminated/fused teeth–report of two cases.
        Int Endod J. 2003; 36: 372-379
        • Jaju P.P.
        • Jaju S.P.
        Clinical utility of dental cone-beam computed tomography: current perspectives.
        Clin Cosmet Investig Dent. 2014; 6: 29-43
        • Yang R.
        • Yang C.
        • Liu Y.
        • et al.
        Evaluate root and canal morphology of primary mandibular second molars in Chinese individuals by using cone-beam computed tomography.
        J Formos Med Assoc. 2013; 112: 390-395
        • Serene T.P.
        • Spolsky V.W.
        Frequency of endodontic therapy in a dental school setting.
        J Endod. 1981; 7: 385-387
        • Choi M.R.
        • Moon Y.M.
        • Seo M.S.
        Prevalence and features of distolingual roots in mandibular molars analyzed by cone-beam computed tomography.
        Imaging Sci Dent. 2015; 45: 221-226
        • Ahmed H.A.
        • Abu-bakr N.H.
        • Yahia N.A.
        • Ibrahim Y.E.
        Root and canal morphology of permanent mandibular molars in a Sudanese population.
        Int Endod J. 2007; 40: 766-771
        • Wolf T.G.
        • Paque F.
        • Zeller M.
        • et al.
        Root canal morphology and configuration of 118 mandibular first molars by means of micro-computed tomography: an ex vivo study.
        J Endod. 2016; 42: 610-614
        • Souza-Flamini L.E.
        • Leoni G.B.
        • Chaves J.F.
        • et al.
        The radix entomolaris and paramolaris: a micro-computed tomographic study of 3-rooted mandibular first molars.
        J Endod. 2014; 40: 1616-1621
        • Rosen E.
        • Taschieri S.
        • Del Fabbro M.
        • et al.
        The diagnostic efficacy of cone-beam computed tomography in endodontics: a systematic review and analysis by a hierarchical model of efficacy.
        J Endod. 2015; 41: 1008-1014
        • Huang C.C.
        • Chang Y.C.
        • Chuang M.C.
        • et al.
        Evaluation of root and canal systems of mandibular first molars in Taiwanese individuals using cone-beam computed tomography.
        J Formos Med Assoc. 2010; 109: 303-308
        • Plotino G.
        • Tocci L.
        • Grande N.M.
        • et al.
        Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: a cone-beam computed tomography study in vivo.
        J Endod. 2013; 39: 1545-1548
        • Zhang R.
        • Wang H.
        • Tian Y.Y.
        • et al.
        Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals.
        Int Endod J. 2011; 44: 990-999
        • Scarfe W.C.
        • Levin M.D.
        • Gane D.
        • Farman A.G.
        Use of cone beam computed tomography in endodontics.
        Int J Dent. 2009; 2009: 634567
        • Melton D.C.
        • Krell K.V.
        • Fuller M.W.
        Anatomical and histological features of C-shaped canals in mandibular second molars.
        J Endod. 1991; 17: 384-388
        • Fan B.
        • Cheung G.S.
        • Fan M.
        • et al.
        C-shaped canal system in mandibular second molars: part I–anatomical features.
        J Endod. 2004; 30: 899-903

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      • Corrigendum
        Journal of EndodonticsVol. 44Issue 3
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          Corrigendum to ‘Complicated Root Canal Configuration of Mandibular First Premolars Is Correlated with the Presence of the Distolingual Root in Mandibular First Molars: A Cone-beam Computed Tomographic Study in Taiwanese Individuals’ [Journal of Endodontics 43 (2017) 1064–1071]
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