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Root canal anatomy of human permanent mandibular incisors and mandibular canines: A systematic review.

ABSTRACT: Mandibular incisors and canines show variations in their root canal anatomy. It is imperative to be aware of these variations to lower the frequency of missed canals. The objective was to systematically review the existing studies to recognize the root and root canal anatomy of the mandibular incisors and canines among the population of various geographical locations, as studied by different methods. This systematic review was registered in the International Prospective Register of Systematic Reviews database under the number CRD42020185146. An exhaustive search was undertaken in three electronic databases - MEDLINE PubMed, EBSCOhost, and Google Scholar - along with hand-searching for the identification of studies. Studies were selected following strict inclusion and exclusion criteria. Selected studies were scored using the Joanna Briggs Institute Critical Appraisal tool for prevalence studies to determine the risk of bias. This review included data from 26 countries including the analysis of 71,404 mandibular anterior teeth. The risk of bias of all included studies was either low or moderate. Overall, it was seen that the percentage of second canals was higher in lateral than in central incisors. Mandibular canines occasionally showed the presence of two roots. Deviations in anatomy were high in the Middle Eastern European countries and the Indian subcontinent. Limitations are as follows: lack of homogeneity across data reported in the studies concerning the methods used to study the root canal anatomy. Diversities seen in the root canal configurations of mandibular incisors and canines vary according to ethnicity, and thus, one must have a thorough knowledge before commencing endodontic treatment.

SUBMITTER: Dhuldhoya DN

PROVIDER: S-EPMC9274686 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundRelatively high incidence of single canals with oval or round shape were observed in human mandibular incisors. In order to investigate the influence of the root canal morphology on root canal preparation, the shaping outcome of ProTaper NEXT in oval and round canals of mandibular incisors were evaluated by using micro-computed tomography (micro-CT) analysis.MethodsThis experiment was approved by the School Medical Ethics Committee. The sample size calculation was conducted using G*Power software. Intact mandibular incisors with a single canal were selected. Oval canals (2 < aspect ratio (AR) ≤ 4) and round canals (AR ≤ 2) were pair-matched according to canal length, and assigned to two experimental groups (13 per group). ProTaper NEXT was used for root canal preparation for both groups. Untouched canal wall (UCW), root canal morphological parameters and three-dimensional (3D) dentin thickness were evaluated in the entire root canal and each canal third after micro-CT scanning.Statistical analysisData were collected and analyzed with Mann-Whitney test and Friedman test using SPSS statistics software 25 (P < 0.05). Additionally, correlations of UCW area with canal morphological parameters were also investigated.ResultsAfter root canal preparation, no significant difference was observed in all analyzed parameters in the apical third between oval and round canal groups (P > 0.05). In the coronal two thirds of the canal, the post-operative structure model index (SMI), form factor and roundness were significantly increased, while the AR was significantly decreased in both groups (P < 0.05). In addition, in the coronal two thirds, significantly more UCW and higher UCWΔ% was observed in oval canal group (P < 0.05). Furthermore, UCW correlated very strongly to canal major diameter (0.924) and initial volume (0.938), and strongly to canal form factor (- 0.724), minor diameter (0.799) and canal area (0.882). Proximal dentin wall was associated with significantly thinner pre-operative dentin thickness and higher amount of dentin removal after root canal preparation in both oval and round canal groups.Conclusions(1) Both types of canals were more conical after root canal preparation, but oval root canals tend to leave more UCW area than round canals in the coronal two thirds of mandibular incisors, which contributes to the challenge for endodontic infection control. (2) Root canal preparation usually results in excessive dentin removal in the proximal dentin wall comparing with buccal and lingual walls in both types of canals of mandibular incisors.

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Root canal anatomy of human permanent mandibular incisors and mandibular canines: A systematic review.

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