Cone-Beam Computed Tomographic Study of the Internal Anatomy of Lower Anterior Teeth

Background A thorough knowledge of the root and canal morphology and their possible variations are essential for successful endodontic treatment. Methods like staining and clearing techniques, cross sectional method can provide precise information on root canal systems, however, these methods are invasive. Cone-beam computed tomography (CBCT) is the 3-dimensional scans of the maxillofacial skeleton that best visualizes canal morphology and helps in identifying additional canals and roots in vivo. Objective To investigate the root canal configuration of mandibular anterior teeth using Conebeam computed tomography. Method A total of 2910 CBCT images, comprising 970 central incisors, lateral incisors, and canines each from 485 patients were assessed. The following assessments were made: (1) The number of roots and root canals (2) Canal configuration according to Vertucci's classification (3) Bilateral occurrences for variations. Also, the gender and age of patients were noted. Result The study revealed mandibular anterior teeth predominantly had 1 root with Type I (79.79%, 77.11%, 91.34%) canal configuration followed by type III (20.2%, 22.67%, 5.15%) in central, lateral and canine respectively. Almost 90% incisors had symmetry in the canal configurations. No statistical correlation was found between the gender and root canal configurations. Type III canal configurations in canines were present more in elder age group. Conclusion Clinicians must be aware that each tooth may display a different number of roots and types of canal configurations. During endodontic treatment, presuming lower anterior teeth with single root and single canal may lead to missed canals and consequently, treatment failure.