Apical root canal anatomy in the mesiobuccal root of maxillary first molars: influence of root apical shape and prevalence of apical foramina - a micro-CT study

Int Endod J. 2019 Aug;52(8):1218-1227. doi: 10.1111/iej.13109. Epub 2019 Mar 28.

Abstract

Aim: To determine whether a relationship exists between the apical shape of roots and root canal system complexity by performing a micro-computed tomography analysis.

Methodology: One hundred extracted permanent maxillary first molars were scanned using a micro-computed tomography device at 19.6 μm voxel size. Two groups of mesiobuccal roots were formed according to the root aspect ratio value in the apical 3-mm cross-sectional level ('<2 and ≥ 2.00'). Data were recorded regarding the number and presence of accessory canals and their location, isthmus, presence of the mesiobuccal canal and dentine thickness. Depending on the analysed variable, Mann-Whitney U test and Z-test for proportions were used to compare groups. The significant level was set at 5%.

Results: Mesiobuccal roots with an aspect ratio ≥ 2.00 at the apical 3-mm cross-sectional level had higher percentages of accessory canals, apical foramina and MB2 root canals in the apical 3 mm. The vertical average distance from the accessory foramina and origin from the anatomic apex was 1.40 and 2.19 mm, respectively. Overall, 21.8% of the accessory canals had their origin coronal to a 3-mm root resection line. There was no difference between the groups regarding dentine thickness.

Conclusion: The shape of the apical 3 mm of maxillary first molar mesiobuccal roots was a predictive factor for the presence of complex root canal systems. Roots with a lower aspect ratio had less complex apical anatomy.

Keywords: anatomy; apex; micro-computed tomography; microsurgery; root canal.

MeSH terms

  • Cross-Sectional Studies
  • Dental Pulp Cavity*
  • Molar
  • Prevalence
  • Tooth Root*
  • X-Ray Microtomography