[Anatomic study of canal isthmuses of mandibular permanent incisors by micro-CT]

To investigate the anatomic feature of the canal isthmus of mandibular permanent incisors by Micro-CT.

Thirty-three mandibular permanent incisors with two canals were selected through the radiograph in proximal view. These teeth were then scanned using Micro-CT and reconstructed. The scanning layer thickness was 20 microm. We observed the apical 6 mm of the 33 roots, and 300 sections were gained each tooth, giving a total of 9900 sections. The numbers of canals at each level in the apical 6 mm were recorded. The numbers of sections showing isthmuses at each level of the root canals were recorded too. Data were analyzed using the Chi-square statistic to test the null hypothesis that location of the sections in each of the apical 6 mm and presence of the isthmus were independent. The minimum root canal wall thickness was measured in each of the apical 6 mm of the roots.

Isthmuses were found to be present at all levels with prevalence from 10.0% to 85.5%. The Chi-square test indicated a significant difference in the distribution of isthmuses with section (P = 0.0O1). The incidence of isthmuses was higher at the apical 3-6 mm level, and the highest incidence (85.5%) was at 5 mm level. There were many more sections containing complete isthmuses (49.7%) than those containing partial isthmuses (4.5%). The thickness of the minimum root canal was less than 0.5 mm.

The mandibular incisors have a high incidence of isthmus and are narrow in proximal direction. Debridement of the isthmus is a major challenge during surgical and nonsurgical root canal treatment.