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Anatomical Investigation of C-shaped Root Canal Systems of Mandibular Molars in a Middle Eastern Population: A CBCT
Maria Feghali1, Carla Jabre2, Gaby Haddad3
1Department of Endodontics, Saint Joseph University, Beirut, Lebanon, Phone: +961 9613226197, e-mail: maria-feghali@hotmail.com, Orcid: https://orcid.org/0000-0003-2867-0674.
Aim:
The aim of this study is to identify the prevalence of C-shaped root canal systems in mandibular first and second molars in a Lebanese population, and to determine the relationship between C-shaped root canal systems and different factors (age, gender, and tooth location) and to examine the root canal system's morphology along the root.
Materials And Methods:
The presence of C-shaped root canal systems in 648 mandibular molars from 257 patients was analyzed using cone-beam computed tomography (CBCT). The sample included 296 and 352 mandibular first and second molars, respectively. The frequency of C-shaped canals, their relationship to gender, age, and tooth location, and unilateral or bilateral occurrences were noted. A 3D Slicer 4.10.1 was then used to classify teeth with identified C-shaped anatomy according to Fan's configuration and to determine the distance between the orifice and the cementoenamel junction (CEJ).
Results:
C-shaped root canal systems were detected in 1.01 and 9.09% of mandibular first and second molars, respectively. In mandibular second molars, the most prevalent configurations were as follows: C1 at the orifice level, C3 at orifice-2 mm, C2 and C3 in the middle third, and C3 at the apical level. There was no correlation with age, gender, and tooth position. The bilateral occurrence happened in 60% of cases. Orifices were at a mean distance of 3.32 mm below the CEJ. The deepest groove was mostly lingual.
Conclusion:
The prevalence of C-shaped root canal systems in the Lebanese population is 1.01 and 9.09% in the first and second mandibular molars, respectively. The CBCT slices showed that the configuration varies along the root and that the orifices are at various distances below the CEJ. Therefore, pre-operatory scans can be beneficial for better understanding and preparation of root canal treatment.
Clinical Significance:
In the Lebanese population, C-shaped mandibular molars are not a rare finding. Clinicians should consider the different configurations and the possible changes along the root.
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