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CC BY-NC-ND 4.0 · Eur J Dent 2018; 12(03): 410-416
DOI: 10.4103/ejd.ejd_82_18
Original Article
Dental Investigation Society

Cone-beam computed tomography analysis on root and canal morphology of mandibular first permanent molar among multiracial population in East Coast Malaysian population

Prunella Ubung Deng
1   Department of Conservative Dentistry, School of Dental Sciences,Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
,
Mohamad Syahrizal Halim
1   Department of Conservative Dentistry, School of Dental Sciences,Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
5   Hospital USM, Health Campus, USM, Kubang Kerian, Kelantan, Malaysia
,
Sam'an Malik Masudi
2   Department of Conservative Dentistry, Faculty of Dentistry, Lincoln University College, Selangor, Malaysia
,
Saaid Al-Shehadat
3   Department of Preventive and Restorative Dentistry, College of Dental Medicine, Sharjah University, Sharjah, UAE
,
Basaruddin Ahmad
4   Department of Dental Public Health, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
› Author Affiliations
Further Information

Publication History

Publication Date:
16 September 2019 (online)

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ABSTRACT

Objective: The aim of this study is to investigate the variations in the number of root and canal in the mandibular first permanent molars (MFPMs) teeth in East Coast Malaysian population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images which show MFPMs recorded in HUSM Dental Clinic between January 2015 and June 2016 was obtained and analyzed for their number of roots and canals. A total of 208 CBCT images of MFPMs were collected; 118 patients had unilateral molars and 90 patients had bilateral molars. The following observations were made: (1) root number; (2) number of canals per root; and (3) comparisons of number of roots and canals according to gender, ethnicity, and position. Results: The majority of cases of bilateral MFPM had the same number of roots (95.6%, 95% confidence interval [CI]: 89.01%, 98.78%) on both the right and left side and only 4 cases (4.4%, 95% CI: 1.22%, 10.99%) had 3 roots on the right and 2 roots on the left sides. The majority of cases had the same number of canals on both sides (66.7%, 95% CI: 55.95, 76.26%) and 33.3% (95% CI: 23.74%, 44.05%) with unequal number of canals. The occurrence of the number of canals was not independent of the sides of the arch (P < 0.001) and there was statistically significantly greater proportion of cases who had greater number of canals on the right side than the left (P = 0.03). The prevalence of right single-rooted MFPM was very small at 0.3% (n = 1) in a Malay male (95% CI: 0.00, 1.83) and the most prevalent was two roots first molar (88.4%). The number of roots was not associated with sex or ethnic group (P > 0.05). The MFPM with a single root was found to have only one mesial canal. For two rooted MFPM, the most prevalent occurrence was two canals at the mesial and one canal at the distal roots (59%); followed by single canals in each mesial and distal (21%) and double canals per root (18%). Three roots MFPM have either single or double canals in the mesial root and double canals in the distal root. Conclusions: The majority of population in the East Coast region of Malaysia has two roots and three root canals in their MFPMs. There was no difference in the number of roots between gender and ethnic and canals between ethnic.

Key words:

Cone-beam computed tomography - Malaysian population - mandibular first permanent molar anatomy - root canal anatomy
 

  • REFERENCES

  • 1 Witherspoon DE, Small JC, Regan JD. Missed canal systems are the most likely basis for endodontic retreatment of molars. Tex Dent J 2013; 130: 127-39
    PubMedGoogle Scholar
  • 2 Zadik Y, Sandler V, Bechor R, Salehrabi R. Analysis of factors related to extraction of endodontically treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 106: 31-5
    Google Scholar
  • 3 Ahmed HA, Abu-bakr NH, Yahia NA, Ibrahim YE. Root and canal morphology of permanent mandibular molars in a Sudanese population. Int Endod J 2007; 40: 766-71
    CrossrefPubMedGoogle Scholar
  • 4 Chandra SS, Chandra S, Shankar P, Indira R. Prevalence of radix entomolaris in mandibular permanent first molars: A study in a South Indian population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 112: 77-82
    CrossrefPubMedGoogle Scholar
  • 5 Huang CC, Chang YC, 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: 303-8
    CrossrefPubMedGoogle Scholar
  • 6 Park JB, Kim N, Park S, Kim Y, Ko Y. 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
    PubMedGoogle Scholar
  • 7 Park JB, Kim N, Park S, Ko Y. Evaluation of number of roots and root anatomy of permanent mandibular third molars in a Korean population, using cone-beam computed tomography. Eur J Dent 2013; 7: 296-301
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Schäfer E, Breuer D, Janzen S. The prevalence of three-rooted mandibular permanent first molars in a German population. J Endod 2009; 35: 202-5
    CrossrefPubMedGoogle Scholar
  • 9 Schumacher C. Endodontic treatment of a mandibular first molar with radix entomolaris: A case report. Endod Pract Today 2008; 2: 301-4
    Google Scholar
  • 10 Shemesh A, Levin A, Katzenell V, Ben Itzhak J, Levinson O, Zini A. et al Prevalence of 3- and 4-rooted first and second mandibular molars in the Israeli population. J Endod 2015; 41: 338-42
    CrossrefPubMedGoogle Scholar
  • 11 Tu MG, Tsai CC, Jou MJ, Chen WL, Chang YF, Chen SY. et al. Prevalence of three-rooted mandibular first molars among Taiwanese individuals. J Endod 2007; 33: 1163-6
    CrossrefPubMedGoogle Scholar
  • 12 Yang Y, Zhang LD, Ge JP, Zhu YQ. Prevalence of 3-rooted first permanent molars among a Shanghai Chinese population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110: e98-101
    CrossrefPubMedGoogle Scholar
  • 13 Touré B, Faye B, Kane AW, Lo CM, Niang B, Boucher Y. et al Analysis of reasons for extraction of endodontically treated teeth: A prospective study. J Endod 2011; 37: 1512-5
    CrossrefPubMedGoogle Scholar
  • 14 Nur BG, Ok E, Altunsoy M, Aglarci OS, Colak M, Gungor E. et al. Evaluation of the root and canal morphology of mandibular permanent molars in a South-Eastern Turkish population using cone-beam computed tomography. Eur J Dent 2014; 8: 154-9
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Reuben J, Velmurugan N, Kandaswamy D. The evaluation of root canal morphology of the mandibular first molar in an Indian population using spiral computed tomography scan: An in vitro study. J Endod 2008; 34: 212-5
    CrossrefPubMedGoogle Scholar
  • 16 Wang Y, Zheng QH, Zhou XD, Tang L, Wang Q, Zheng GN. et al. Evaluation of the root and canal morphology of mandibular first permanent molars in a Western Chinese population by cone-beam computed tomography. J Endod 2010; 36: 1786-9
    CrossrefPubMedGoogle Scholar
  • 17 Zaatar EI, al Anizi SA, al Duwairi Y. A study of the dental pulp cavity of mandibular first permanent molars in the Kuwaiti population. J Endod 1998; 24: 125-7
    CrossrefPubMedGoogle Scholar
  • 18 Curzon ME. Miscegenation and the prevalence of three-rooted mandibular first molars in the Baffin Eskimo. Community Dent Oral Epidemiol 1974; 2: 130-1
    CrossrefPubMedGoogle Scholar
  • 19 Neelakantan P, Subbarao C, Subbarao CV. 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: 1547-51
    CrossrefPubMedGoogle Scholar
  • 20 Walker RT. Root form and canal anatomy of mandibular first molars in a Southern Chinese population. Endod Dent Traumatol 1988; 4: 19-22
    CrossrefPubMedGoogle Scholar
  • 21 Loh HS. Incidence and features of three-rooted permanent mandibular molars. Aust Dent J 1990; 35: 434-7
    CrossrefPubMedGoogle Scholar
  • 22 Tratman E. Three-rooted lower molars in man and their racial distribution. Br Dent J 1938; 64: 74
    Google Scholar
  • 23 de Souza-Freitas JA, Lopes ES, Casati-Alvares L. Anatomic variations of lower first permanent molar roots in two ethnic groups. Oral Surg Oral Med Oral Pathol 1971; 31: 274-8
    CrossrefPubMedGoogle Scholar
  • 24 Reichart PA, Metah D. Three-rooted permanent mandibular first molars in the Thai. Community Dent Oral Epidemiol 1981; 9: 191-2
    CrossrefPubMedGoogle Scholar
  • 25 Tu MG, Huang HL, Hsue SS, Hsu JT, Chen SY, Jou MJ. et al. Detection of permanent three-rooted mandibular first molars by cone-beam computed tomography imaging in Taiwanese individuals. J Endod 2009; 35: 503-7
    CrossrefPubMedGoogle Scholar
  • 26 Green RM. The position of the mental foramen: A comparison between the Southern (Hong Kong) Chinese and other ethnic and racial groups. Oral Surg Oral Med Oral Pathol 1987; 63: 287-90
    CrossrefPubMedGoogle Scholar
  • 27 Manabe Y, Ito R, Kitagawa Y, Oyamada J, Rokutanda A, Nagamoto S. et al. Non-metric tooth crown traits of the Thai, Aka and Yao tribes of Northern Thailand. Arch Oral Biol 1997; 42: 283-91
    CrossrefPubMedGoogle Scholar
  • 28 Chuah OA, Shukri AS, Yeoh MS. Indian muslims in Malaysia: A sociological analysis of a minority ethnic group. J Muslim Minor Aff 2011; 31: 217-30
    Google Scholar
  • 29 Stark J. Indian muslims in Malaysia: Images of shifting identities in the multi-ethnic statey. J Muslim Minor Aff 2006; 26: 383-98
    Google Scholar
  • 30 Turner 2nd CG. Three-rooted mandibular first permanent molars and the question of American Indian origins. Am J Phys Anthropol 1971; 34: 229-41
    CrossrefPubMedGoogle Scholar
  • 31 Sperber GH, Moreau JL. Study of the number of roots and canals in senegalese first permanent mandibular molars. Int Endod J 1998; 31: 117-22
    CrossrefPubMedGoogle Scholar
  • 32 Miloglu O, Arslan H, Barutcigil C, Cantekin K. Evaluating root and canal configuration of mandibular first molars with cone beam computed tomography in a Turkish population. J Dent Sci 2013; 8: 80-6
    CrossrefGoogle Scholar
  • 33 Song JS, Kim SO, Choi BJ, Choi HJ, Son HK, Lee JH. 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: e56-60
    CrossrefPubMedGoogle Scholar
  • 34 Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. Int Endod J 2002; 35: 56-62
    CrossrefPubMedGoogle Scholar
  • 35 Manning SA. Root canal anatomy of mandibular second molars. Part I. Int Endod J 1990; 23: 34-9
    CrossrefPubMedGoogle Scholar
  • 36 Gulabivala K, Aung TH, Alavi A, Ng YL. Root and canal morphology of burmese mandibular molars. Int Endod J 2001; 34: 359-70
    CrossrefPubMedGoogle Scholar
  • 37 Nair MK, Nair UP. Digital and advanced imaging in endodontics: A review. J Endod 2007; 33: 1-6
    CrossrefPubMedGoogle Scholar