Prevalence of a Second Root and Canal in Mandibular and Maxillary Canines in a Saudi Arabian Population: A Cone-beam Computed Tomography Study
Canines, CBCT, Root canal morphology, Saudi population
Citation Information :
Prevalence of a Second Root and Canal in Mandibular and Maxillary Canines in a Saudi Arabian Population: A Cone-beam Computed Tomography Study. J Contemp Dent Pract 2019; 20 (7):773-777.
Aim: This study evaluated the prevalence of a second root and canal, gender differences, and bilateral symmetry of mandibular and maxillary permanent canines in a Saudi Arabian population using a cone-beam computed tomography (CBCT).
Materials and methods: The first step was to evaluate CBCT images of 208 patients with 794 canines (410 mandibular and 384 maxillary canines). The second step was to identify the number of roots, number of canals, and canal configurations based on Vertucci's classification to investigate the prevalence of a second root and a second canal, gender differences, and bilateral symmetry. A Z test evaluated differences in the independent proportions; a Chi-square test determined differences between genders and Cohen's Kappa test assessed bilateral symmetry.
Results: The prevalence of two roots and two canals in mandibular canines was 2.7% and 9.3%, respectively, and Vertucci's type III appeared in 6.1%, and Vertucci's type V appeared in 3.2%. In maxillary canines, there were no two-rooted teeth, and only 1% of two canals were present with Vertucci's type III. There were no statistically significant differences between genders in both mandibular and maxillary canines. High bilateral symmetries of roots and canals appeared in mandibular canines (95.5% and 91.1%, respectively) and maxillary canines (100% and 98.9%, respectively).
Conclusion: One root, one canal, and Vertucci's type I are the primary and typical characteristics of mandibular and maxillary canines. The presence of a second root in mandibular canines is small, although the presence of two canals is not unusual. Conversely, it is rare to find a second root and canal in maxillary canines.
Clinical significance: Mandibular canines showed bilateral asymmetry (8.9%) in the number of canals between the right and left sides, which could be of clinical importance when planning root canal treatment (RCT) on contralateral canines.
Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984 Nov;58(5):589–599. DOI: 10.1016/0030-4220(84)90085-9.
Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod Top 2005;10(5):3–29. DOI: 10.1111/j.1601-1546.2005.00129.x.
Martins JNR. Root and root canal morphology of the permanent dentition in a Caucasian population: a cone-beam computed tomography study. 2017;50(11):1013–1026. DOI: 10.1111/iej.12724.
Pineda F, Kuttler Y. Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals. Oral Surg Oral Med Oral Pathol 1972 Jan;33(1):101–110. DOI: 10.1016/0030-4220(72)90214-9.
Ouellet R. Mandibular permanent cuspids with two roots. J Can Dent Assoc 1995 Feb;61(2):159–161.
Aminsobhani M, Sadegh M, et al. Evaluation of the root and canal morphology of mandibular permanent anterior teeth in an Iranian population by cone-beam computed tomography. J Dent (Tehran) 2013 May;10(4):358–366.
Pecora JD, Sousa Neto MD, et al. Internal anatomy, direction and number of roots and size of human mandibular canines. Braz Dent J 1993;4(1):53–57.
Zhao Y, Dong Y, et al. Cone-beam computed tomography analysis of root canal configuration of 4 674 mandibular anterior teeth. Beijing Da Xue Xue Bao [Internet]. 2014 Feb;46(1):95–99. Available from: http://europepmc.org/abstract/MED/24535357.
Mirzaie M, Zaban PT, et al. Cone-beam Computed Tomography Study of Root Canals in a Hamadani Population in Iran. Avicenna J Dent Res 2012;4:93–99.
Singh S, Pawar M. Root and canal morphology of mandibular incisors and canines in South Asian Indian population by canal staining and tooth clearing technique. Endodontology 2016;28:148–153.
Zhengyan Y, Keke L, et al. Cone-beam computed tomography study of the root and canal morphology of mandibular permanent anterior teeth in a Chongqing population. Ther Clin Risk Manag 2016;12: 19–25.
Soleymani A, Namaryan N, et al. Root Canal Morphology of Mandibular Canine in an Iranian Population: A CBCT Assessment. Iran Endod J 2017;12(1):78–82. DOI: 10.22037/iej.2017.16.
Green D. Double canals in single roots. Oral Surg Oral Med Oral Pathol 1973 May;35(5):689–696. DOI: 10.1016/0030-4220(73)90037-6.
Yousef AD, Abdullah A, et al. Cone-beam computed tomographic evaluation of root canal morphology of mandibular canines in a Saudi subpopulation. Saudi Endod J 2019;9:113–118.
Rahmatulla M, Wyne AH. Bifid roots in a mandibular canine: Report of an unusual case. Saudi Dent J 1993;5:77–78.
Balto HA, Al-Wakeel M. Mandibular canine with two root canals-case report. Egypt Dent J 2007;53:2535–2538.
Alenezi MA. Permanent mandibular canine with two roots and two root canals: Two case reports. Saudi Endod J 2016;6:98–100.
Al Dahman Yousef H, Al Hawwas Abdullah Y. A Root Canal Retreatment of Permanent Mandibular Canine with Two Canals - A Case Report. Adv Dent & Oral Health 2017;4:4–7.
Sahoo HS, Amalavathy RK, et al. A Case Report on Endodontic Management of a Rare Vertucci Type III Maxillary Canine. 2019; 2019:4154067. DOI: 10.1155/2019/4154067.
Pan JYY, Parolia A, et al. Root canal morphology of permanent teeth in a Malaysian subpopulation using cone-beam computed tomography. BMC Oral Health 2019 Jan;19(1):14. DOI: 10.1186/s12903-019-0710-z.
Patel S, Dawood A, et al. New dimensions in endodontic imaging: part 1. Conventional and alternative radiographic systems. Int Endod J 2009 Jun;42(6):447–462. DOI: 10.1111/j.1365-2591.2008.01530.x.
Neelakantan P, Subbarao C, et al. 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 c. J Endod 2010 Sep;36(9):1547–1551. DOI: 10.1016/j.joen.2010.05.008.
von Zuben M, Martins JNR, et al. Worldwide Prevalence of Mandibular Second Molar C-Shaped Morphologies Evaluated by Cone-Beam Computed Tomography. J Endod 2017;43(9):1442–1447. DOI: 10.1016/j.joen.2017.04.016.
Caliskan MK, Pehlivan Y, et al. Root canal morphology of human permanent teeth in a Turkish population. J Endod 1995 Apr;21(4):200–204. DOI: 10.1016/S0099-2399(06)80566-2.
Miyoshi S, Fujiwara J, et al. Bifurcated root canals and crown diameter. J Dent Res 1977 Nov;56(11):1425. DOI: 10.1177/00220345770560112901.
Bellizzi R, Hartwell G. Clinical investigation of in vivo endodontically treated mandibular anterior teeth. J Endod 1983 Jun;9(6):246–248. DOI: 10.1016/S0099-2399(86)80022-X.
Kaffe I, Kaufman A, et al. Radiographic study of the root canal system of mandibular anterior teeth. Int Endod J 1985 Oct;18(4):253–259. DOI: 10.1111/j.1365-2591.1985.tb00452.x.
Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod 2004 Jun;30(6):391–398. DOI: 10.1097/00004770-200406000-00004.
Bakianian Vaziri P, Kasraee S, et al. Root Canal Configuration of One-rooted Mandibular Canine in an Iranian Population: An In Vitro Study. J Dent Res Dent Clin Dent Prospects 2008;2(1):28–32.
Rahimi S, Milani AS, et al. Prevalence of two root canals in human mandibular anterior teeth in an Iranian population. Indian J Dent Res 2013;24(2):234–236. DOI: 10.4103/0970-9290.116694.
Somalinga Amardeep N, Raghu S, et al. Root canal morphology of permanent maxillary and mandibular canines in Indian population using cone beam computed tomography. Anat Res Int 2014;2014:731859. DOI: 10.1155/2014/731859.
Martins JNR, Marques D, et al. Gender influence on the number of roots and root canal system configuration in human permanent teeth of a Portuguese subpopulation. Quintessence Int 2018;49:103–111. DOI: 10.3290/j.qi.a39508.
Martins JNR, Marques D, et al. Prevalence Studies on Root Canal Anatomy Using Cone-beam Computed Tomographic Imaging: A Systematic Review. J Endod 2019;45(4):372–386.