Influence of root shape on canal complexity at the mandibular molar apical surgical resection level: A micro-CT study

Arch Oral Biol. 2024 Aug:164:105983. doi: 10.1016/j.archoralbio.2024.105983. Epub 2024 Apr 27.

Abstract

Objectives: This study aimed to investigate the relationship between the aspect ratios of mandibular molar roots at the apical 3-mm level and their root canal complexity.

Design: This study used micro-CT imaging to analyze 163 two-rooted mandibular molars. The aspect ratios of the roots at the apical 3-mm level were categorized as "< 2.75" or "≥ 2.75" (mesial) and "< 1.75" or "≥ 1.75" (distal). A two-dimensional (2D) analysis focused on four apical axial cross-section levels to determine the presence of main and accessory canals and isthmus. Additionally, a three-dimensional (3D) assessment of the apical 4-mm of both roots examined main and accessory canals, apical foramina, apical deltas, and middle mesial canals.

Results: Mesial roots with aspect ratios ≥ 2.75 showed a higher number of main canals at all levels compared to those with aspect ratios < 2.75 at the 3-mm level. Additionally, the ≥ 2.75 group exhibited more accessory canals and a higher average number of accessory canals. The 3D assessment confirmed significantly more accessory canals and apical foramina in the ≥ 2.75 group. The prevalence of roots with apical deltas was nearly double in the ≥ 2.75 group, and middle mesial canals were exclusively found in this group. In the distal root, the ≥ 1.75 group showed a significantly higher number of main canals at all axial levels. No significant differences were observed between groups in terms of accessory canals, apical foramina, or deltas.

Conclusions: A higher root aspect ratio is related to higher anatomical complexity.

Keywords: Anatomy; Endodontics; Mandibular molar; Micro-CT; Root canal therapy; Surgery.

MeSH terms

  • Dental Pulp Cavity* / anatomy & histology
  • Dental Pulp Cavity* / diagnostic imaging
  • Humans
  • Imaging, Three-Dimensional / methods
  • Mandible* / anatomy & histology
  • Mandible* / diagnostic imaging
  • Molar* / anatomy & histology
  • Molar* / diagnostic imaging
  • Tooth Apex / anatomy & histology
  • Tooth Apex / diagnostic imaging
  • Tooth Root* / anatomy & histology
  • Tooth Root* / diagnostic imaging
  • X-Ray Microtomography* / methods