Evaluation of the relationship between crown size and root canal morphology of mandibular incisors by cone beam computed tomography (CBCT)

Authors

  • Elnaz Mousavi DDS, Assistant Professor, Department of Endodontics, Faculty of Dentistry, Guilan University Of Medical Sciences, Rasht, Iran

Keywords:

Crown Size, Cone Beam Computed Tomography, Mandibular Incisor, Root Canal Morphology

Abstract

Background: The main reason for the failure of endodontic therapy is the incomplete knowledge about the anatomical variation of root canals. One of the most important factors that leads to the failure of root canal treatment, is missed and untreated major root canals. 

Objective: with respect to the complexity of mandibular incisors treatment and high prevalence of the second canal, and the possibility of the relationship between the crown size and the extra canal in these teeth, the aim of this study was to determine the relationship between crown size and root canal morphology in mandibular incisors with CBCT.

Methods: In this cross-sectional study, mandibular permanent incisors were randomly collected in Qazvin City, Iran, and were mounted in eight ternary groups on a plastic slot, using putty molding material.  After preparation of Scot view, the samples were scanned by CBCT NewTom 5G. Afterward, the mesiodistal and buccolingual dimensions were measured by the software’s measurement tool with a precision within tenths of a millimeter. In the next stage, a multi-planar option and 400% magnification tool of the software were utilized to study axial and cross sectional views of each tooth to determine canal type. Data were analyzed employing one-sample Kolmogorov-Smirnov, Levene, independent- samples t-test and Roc curve by SPSS version 20.

Results: The majority of mandibular incisors have a single canal (63.9% of them had type I canal system). In addition, 36.1% of the roots had two canals, among which, type III was the most common. The mean of maximum mesiodistal and buccolingual diameters in type III was significantly bigger than that in type I (p<0.05), but the means of crown size in the two canal types were not significantly different.

Conclusion: Despite increase in mesiodistal and buccolingual dimension in two canal mandibular incisors with type III canal system, their crown sizes (M-D/F-L index) were not significantly different, in comparison to single canal incisors.

 

References

Huang CH, Chang Y, Chuang MC, Lai TM, Lai JY, Lee BS, 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(4): 303-8. doi: 10.1016/S0929-6646(10)60056-3. PMID: 20434040.

Hoen MM, Pink FE. Contemporary endodontic retreatments: an analysis based on clinical treatment

findings. J Endod. 2002; 28(12): 834-6. doi: 10.1097/00004770-200212000-00010. PMID: 12489654.

Srinivasan R, Raghu R. Labial access for lower anterior teeth – a rational approach. AOSR. 2011; 1(3):

Wein FS. Access cavity preparation and initiating treatment. In: Wein FS, Endodontic therapy. 1996; 25:

-7.

Rankine-Wilson RW, Henry P. The bifurcated root canal in lower anterior teeth. J Am Dent Assoc. 1965;

: 1162-5. doi: 10.14219/jada.archive.1965.0189. PMID: 14284639.

Vertucci FJ. Root canal anatomy of the mandibular anterior teeth. J Am Dent Assoc. 1974; 89: 369-71. doi:

14219/jada.archive.1974.0391. PMID: 4527223.

Nagas E, Gorduysus O, Gorduysus M. Relation between bucco-lingual dimension and root canal

morphology in mandibular incisors: a morphometric study. Cdr. 2011; 35(2): 10-3.

Neelakantan P, Chandana S, Rosbni A, Subbarao CV. Cone-Beam computed tomography study of root and

canal morphology of maxillary first and second molars in an Indian population. J Endod. 2010; 36(10):

-7. doi: 10.1016/j.joen.2010.07.006. PMID: 20850665.

Weng XL, Yu SB, Zbao SL, Wang HG. Root canal morphology of permanent maxillary teeth in the han

nationality in Chinese guanzhong area: A new modified root canal staining technique. J Endod. 2009;

(5): 651-6. doi: 10.1016/j.joen.2009.02.010. PMID: 19410077.

AL-Qudah AA, Awawdeh LA. Root canal morphology of mandibular incisore in a jordanian population.

Int Endod J. 2006; 39(11): 873-7. doi: 10.1111/j.1365-2591.2006.01159.x. PMID: 17014525.

Warren EM, Laws AJ. The relationship between crown size and the incidence of bifid root canals in

mandibular incisore teeth. Oral Surg Oral Med Oral Pathol. 1981; 52(4): 425-9. doi: 10.1016/0030- 4220(81)90343-1. PMID: 6946367.

Neelakantan P, Subbarao CH, Subbarao CHV. Comparative evaluation of modified canal staining and

clearing technique, cone-beam computed tomography, peripheral quantitative computed tomography, spiral

computed tomography and plain and contrast medium-enhanced digital radiography in studying root canal

morphology. J Endod. 2010; 36(9): 1547-51. doi: 10.1016/j.joen.2010.05.008. PMID: 20728725.

Miracle AC, Mukherji SK. Conebeam CT of the head and neck, parts 2 clinical applications. AJNR Am J

Neuroradiol. 2009; 30(7): 1285-92. doi: 10.3174/ajnr.A1654. PMID: 19461061.

Vertucci FJ, Fla G. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol.

; 58(5): 589-99. doi: 10.1016/0030-4220(84)90085-9. PMID: 6595621.

Krasner P, Rankow HJ. Anatomy of the pulp chamber floor. J Endod. 2004; 30(1): 5-16. doi:

1097/00004770-200401000-00002.

Boruah LB, Bhuyan AC. Morpholigic characteristics of root canal of mandibular incisors in north-east

indian population: An in vitro study. J Conserv Dent. 2011; 14(4): 346-50. doi: 10.4103/0972-0707.87195.

PMID: 22144800, PMCID: PMC3227278.

Rahimi SA, Milani AS, Serqiz YO, Nazafati SA, Lotfi ME. Prevalence of two root canals in human

mandibular anterior teeth in an Iranian population. Indian J Dent Res. 2013; 24(2): 234-6. doi:

4103/0970-9290.116694. PMID: 23965453.

Didar SHG, Ranjdar MT, Dler AK, Hawzhen MM, Shokan AH, Araas JN. Prevalence of two root canals in

human mandibular lateral incisor teeth. IOSR-JDMS. 2015; 14(9): 104-6.

Shaikh MA, Kalhoro FA, Sangi LA. Frequency of second canal in mandibular lateral incisors (in-vitro).

Pak Oral Dent J. 2014; 34(1): 147-9.

Scarlatescu S, Didilescu AC, Stratul SI, Rusu D, Grigore M, Greabu M, et al. Root canal morphology of

mandibular central incisors in a south-eastern Romanian population: Endodontic and periodontal

implications. Timis Med J. 2010; 60(4): 280-3.

Mauger MJ, Schindler WG, Walker WA. An evaluation of canal morphology at different levels of root

resection in mandibular incisors. J Endod. 1998; 24(9): 607-9. doi: 10.1016/S0099-2399(98)80120-9.

Peck H, Peck S. An index for assessing tooth shape deviations as applied to the mandibular incisors. Am J

Orthod. 1972; 61(4): 384-401. PMID: 4501985.

Michetti J, Maret D, Mallet JP, Diemer F. Validation of cone beam computed tomography as a tool to

explore root canal anatomy. J Endod. 2010; 36(7): 1187-90. doi: 10.1016/j.joen.2010.03.029. PMID:

Matherne RP, Anqelopoulos C, Kulild JC, Tira D. Use of Cone-Beam Computed Tomography to identify

root canal systems in vitro. J Endod. 2008; 34(1): 87-9. doi: 10.1016/j.joen.2007.10.016. PMID: 18155501.

Published

2022-01-18

Issue

Section

Articles