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C-shaped canals in mandibular molars of a Brazilian subpopulation: prevalence and root canal configuration using cone-beam computed tomography

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Abstract

Objectives

To assess C-shaped root canal configuration by identifying its prevalence and each configuration type proportion, according to tooth (mandibular first or second molar) and demographic characteristics in a Brazilian population, using cone-beam computed tomography (CBCT). Moreover, it was verified if there is a relationship between root canal configuration observed in two-dimensional reconstructions of CBCT and presence of C-shape.

Methods

Mandibular jaw CBCT scans (184 males and 220 females, aged 15 to 80 years), which presented 1464 mandibular molars (710 first molars and 754 second molars), were assessed. Teeth were evaluated for the presence and type of C-shaped root canals by observing the roots at five levels in CBCT axial reconstructions. Root canal configuration was assessed in panoramic reconstructions. Data were statistically analyzed at a significance level of 5%.

Results

Of the 1464 mandibular molars, 125 (8.5%) were classified as C-shaped. This variation was more prevalent in females (n = 107, 85.6%) and in second molars (n = 108, 86.4%). C1 (uninterrupted C-shaped canal) was the most prevalent type of C-shaped configuration (41.76%), while C5 (no canal lumen) was the least prevalent type (0.96%). Single root with single canal in panoramic reconstructions was the most predominant configuration for C-shaped teeth (n = 54, 43.2%). Fused roots presented 17.2 higher odds of being associated with C-shaped root canals than non-fused roots.

Conclusions

C-shaped root canals were more prevalent in mandibular second molars and in females. Additionally, clinicians should bear in mind the greater possibility of C-shaped configuration in mandibular molars with fused roots.

Clinical relevance

Mandibular molars with C-shaped canals present a clinical challenge. A higher C-shaped proportion was noted in radiographic fused root types, which had 17.2 higher odds of presenting such anatomy when compared to radiographic non-fused roots. Root radiographic features may help in diagnosis of complex C-shaped morphologies.

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References

  1. Alfawaz H, Alqedairi A, Alkhayyal AK, Almobarak AA, Alhusain MF, Martins JNR (2019) Prevalence of C-shaped canal system in mandibular first and second molars in a Saudi population assessed via cone beam computed tomography: a retrospective study. Clin Oral Investig 23:107–112

    Article  Google Scholar 

  2. Martins JNR, Mata A, Marques D, Caramês J (2016) Prevalence of C-shaped mandibular molars in the Portuguese population evaluated by cone-beam computed tomography. Eur J Dent 10:529–535

    Article  Google Scholar 

  3. Raisingani D, Gupta S, Mital P et al (2014) Anatomic and diagnostic challenges of C-shaped root canal system. Int J Clin Pediatr Dent 7:33–37

    Google Scholar 

  4. Vaz De Azevedo KR, Lopes CB, Andrade RHTLR et al (2019) C-shaped canals in first and second mandibular molars from Brazilian individuals: a prevalence study using cone-beam computed tomography. PLoS One 14:1–6

    Article  Google Scholar 

  5. Weine FS, Pasiewicz RA, Rice RT (1988) Canal configuration of the mandibular second molar using a clinically oriented in vitro method. J Endod 14:207–213

    Article  Google Scholar 

  6. Fan B, Cheung GSP, Fan M et al (2004) C-shaped canal system in mandibular second molars: part I--anatomical features. J Endod 30:899–903

    Article  Google Scholar 

  7. Silva EJNL, Nejaim Y, Silva AV et al (2013) Evaluation of root canal configuration of mandibular molars in a Brazilian population by using cone-beam computed tomography: an in vivo study. J Endod 39:849–852

    Article  Google Scholar 

  8. Zheng Q, Zhang L, Zhou X, Wang Q, Wang Y, Tang L, Song F, Huang D (2011) C-shaped root canal system in mandibular second molars in a Chinese population evaluated by cone-beam computed tomography. Int Endod J 44:857–862

    Article  Google Scholar 

  9. Shemesh A, Levin A, Katzenell V, Itzhak JB, Levinson O, Avraham Z, Solomonov M (2017) C-shaped canals-prevalence and root canal configuration by cone beam computed tomography evaluation in first and second mandibular molars-a cross-sectional study. Clin Oral Investig 21:2039–2044

    Article  Google Scholar 

  10. Ladeira DBS, Cruz AD, Freitas DQ, Almeida SM (2014) Prevalence of C-shaped root canal in a Brazilian subpopulation: a cone-beam computed tomography analysis. Braz Oral Res 28:39–45

    Article  Google Scholar 

  11. Martins JNR, Marques D, Silva EJNL, Caramês J, Mata A, Versiani MA (2019) Prevalence of C-shaped canal morphology using cone beam computed tomography - a systematic review with meta-analysis. Int Endod J 52:1556–1572

    Article  Google Scholar 

  12. Cicchetti DV (1994) Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess 6:284–290

    Article  Google Scholar 

  13. Ordinola-Zapata R, Martins JNR, Bramante CM et al (2017) Morphological evaluation of maxillary second molars with fused roots: a micro-CT study. Int Endod J 50:1192–1200

    Article  Google Scholar 

  14. Fan B, Ye W, Xie E, Wu H, Gutmann JL (2012) Three-dimensional morphological analysis of C-shaped canals in mandibular first premolars in a Chinese population. Int Endod J 45:1035–1041

    Article  Google Scholar 

  15. von Zuben M, Martins JNR, Berti L et al (2017) Worldwide prevalence of mandibular second molar C-shaped morphologies evaluated by cone-beam computed tomography. J Endod 43:1442–1447

    Article  Google Scholar 

  16. Torres A, Jacobs R, Lambrechts P et al (2015) Characterization of mandibular molar root and canal morphology using cone beam computed tomography and its variability in Belgian and Chilean population samples. Imaging Sci Dent 45:95–101

    Article  Google Scholar 

  17. Kim SY, Kim BS, Woo J et al (2013) Morphology of mandibular first molars analyzed by cone-beam computed tomography in a Korean population: variations in the number of roots and canals. J Endod 39:1516–1521

    Article  Google Scholar 

  18. Jafarzadeh H, Wu Y (2007) The C-shaped root canal configuration: a review. J Endod 33:517–523

    Article  Google Scholar 

  19. Amoroso-Silva PA, Ordinola-Zapata R, Duarte MA et al (2015) Micro-computed tomographic analysis of mandibular second molars with C-shaped root canals. J Endod 41:890–895

    Article  Google Scholar 

  20. Fan B, Cheung GSP, Fan M et al (2004) C-shaped canal system in mandibular second molars: part II--radiographic features. J Endod 30:904–908

    Article  Google Scholar 

Download references

Funding

This research was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) – Finance Code 001. It was also supported by the CNPq (National Council for Scientific and Technological Development) and FAPERJ. This study is partially funded by CAPES, CNPq, and FAPERJ.

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Authors and Affiliations

  1. Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil

    Yuri Nejaim, Amanda Farias Gomes, Lucas de Paula Lopes Rosado & Deborah Queiroz Freitas

  2. Department of Endodontics, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal

    Jorge N. R. Martins

  3. Centro de Estudo de Medicina Dentária Baseada na Evidência, Faculdade de Medicina Dentária, Universidade de Lisboa, Lisbon, Portugal

    Jorge N. R. Martins

  4. Department of Endodontics, Grande Rio University, Rio de Janeiro, Brazil

    Emmanuel João Nogueira Leal da Silva

  5. Department of Endodontics, Fluminense Federal University, Niterói, Brazil

    Emmanuel João Nogueira Leal da Silva

  6. Department of Endodontics, Dental School of Grande Rio University (UNIGRANRIO), Rua Herotides de Oliveira, 61/902, Icaraí, Niterói, RJ, Brazil

    Emmanuel João Nogueira Leal da Silva

Authors
  1. Yuri Nejaim
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  2. Amanda Farias Gomes
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  3. Lucas de Paula Lopes Rosado
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  4. Deborah Queiroz Freitas
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  5. Jorge N. R. Martins
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  6. Emmanuel João Nogueira Leal da Silva
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Corresponding author

Correspondence to Emmanuel João Nogueira Leal da Silva.

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The authors declare that they have no conflict of interest.

Ethical approval

The local Research Ethics Committee approved this study without restrictions under the protocol number: 27598214.9.0000.5418.

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Nejaim, Y., Gomes, A.F., Rosado, L. et al. C-shaped canals in mandibular molars of a Brazilian subpopulation: prevalence and root canal configuration using cone-beam computed tomography. Clin Oral Invest 24, 3299–3305 (2020). https://doi.org/10.1007/s00784-020-03207-6

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  • DOI: https://doi.org/10.1007/s00784-020-03207-6

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