Prevalence of C-shaped mandibular second molar canals in the population of central Serbia: a cone-beam computed tomography study

Suzana Živanović; Miloš Papić; Mirjana Radović; Aleksandra Mišić; Miloš Živić; Milica Popović

doi:10.2298/VSP181210028Z

Suzana Živanović University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Dentistry
Miloš Papić University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Dentistry
Mirjana Radović University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Dentistry
Aleksandra Mišić University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Dentistry
Miloš Živić University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Dentistry
Milica Popović University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Dentistry

DOI: https://doi.org/10.2298/VSP181210028Z

Keywords: endodontics;, tooth root;, tooth anomalies;, molar;, tomography;, serbia

Abstract

Background/Aim. C-shaped canals are a complex morphological variation of the tooth root canal system that, if present, could greatly affect the outcome of endodontic therapy. The prevalence of these canal configurations varies between the populations of different ethnic and geographical origins. Therefore, the goal of this study was to analyze the prevalence and morphology of mandibular second molar C-shaped canals in the population of Central Serbia. Methods. The study included a total of 199 mandibular second molars receiving a cone-beam computed tomography (CBCT) examination and determining the presence of C-shaped canal systems, their configuration, minimal wall thickness and its relative position on axial cross-sections at the coronal, middle, and apical level. Results. The prevalence of C-shaped mandibular second molars was 5.53%. C1 canal configuration was the most frequent at the coronal cross-section, while C2 configuration was the most frequent at middle and apical cross-sections. Minimal wall thickness decreased going apically, with the mean value of 1.01 mm at the coronal, 0.87 mm at the middle, and 0.67 mm at the apical cross-sections. Minimal wall thickness was mostly directed lingually at all cross-sectional levels. Conclusion. C-shaped canals should be expected in mandibular second molars of the population of Central Serbia. CBCT was shown to be the most valuable technique to determine C-shaped canals and facilitate understanding of the C-shaped canal morphology; its implementation could improve the success of endodontic therapy, especially if the complex root canal configuration is present.

References

Fernandes M, de Ataide I, Wagle R. C-shaped root canal config-uration: A review of literature. J Conserv Dent 2014; 17(4): 312–9.

Sinanoglu A, Helvacioglu-Yigit D. Analysis of C-shaped canals by panoramic radiography and cone-beam computed tomography: root-type specificity by longitudinal distribution. J Endod. 2014; 40(7): 917–21.

Cooke HG, Cox FL. C-shaped canal configurations in mandib-ular molars. J Am Dent Assoc 1979; 99(5): 836–9.

Seo DG, Gu Y, Yi YA, Lee SJ, Jeong JS, Lee Y, et al. A bio-metric study of C-shaped root canal systems in mandibular second molars using cone-beam computed tomography. Int Endod J 2012; 45(9): 807–14.

Ladeira DB, Cruz AD, Freitas DQ, Almeida SM. Prevalence of C-shaped root canal in a Brazilian subpopulation: a cone-beam computed tomography analysis. Braz Oral Res 2014; 28(1): 39–45.

Kirilova J, Topalova-Pirinska S. C-Shaped Configuration of the Root Canal System – Problems and Solutions. J IMAB 2014; 20(1): 504–9.

Zheng Q, Zhang L, Zhou X, Wang Q, Wang Y, Tang L, et al. C-shaped root canal system in mandibular second molars in a Chinese population evaluated by cone-beam computed to-mography. Int Endod J 2011; 44(9): 857–62.

Lopes DS, Câmara AC, Aguiar CM, do Nascimento MD, Farias de Araújo L. A C-Shaped Canal in a Maxillary Second Molar: Prexion 3D Cone-Beam Computed Tomography Analysis. Ac-ta Stomatol Croat 2016; 50(4): 354–8.

European Society of Endodontology. Patel S, Durack C, Abella F, Roig M, Shemesh H, Lambrechts P, et al. European Society of Endodontology position statement: the use of CBCT in endo-dontics. Int Endod J 2014; 47(6): 502–4.

Popovic M, Papic M, Zivanovic S, Acovic A, Loncarevic S, Ristic V. Cone-Beam Computed Tomography Study of the Root Canal Morphology of Mandibular Anterior Teeth in Serbian Popula-tion. Ser J Exp Clin Res 2018; 19(1): 27–34.

Popovic M, Papic M, Acovic A, Zivanovic S, Kanjevac T. Cone-beam computed tomography study of root number and root canal configuration of premolars in Serbian population. Med Pregl 2018; 71(3–4): 100–7.

Popovic M, Zivanovic S, Vucicevic T, Grujovic M, Papic M, Kanjevac T. Cone-beam computed tomography study of tooth root and canal morphology of permanent molars in a Serbian popula-tion. Vojnosanit Pregl 2018; doi: 10.2298/VSP180322100P (In Press).

Fan B, Cheung GSP, Fan M, Gutmann JL, Bian Z. C-shaped ca-nal system in mandibular second molars: Part I--Anatomical features. J Endod 2004; 30(12): 899–903.

Rahimi S, Shahi S, Lotfi M, Zand V, Abdolrahimi M, Es’haghi R. Root canal configuration and the prevalence of C-shaped ca-nals in mandibular second molars in an Iranian population. J Oral Sci 2008; 50(1): 9–13.

Vertucci FJ. Root canal morphology and its relationship to en-dodontic procedures. Endod Top 2005; 10(1): 3–29.

Shemesh A, Levin A, Katzenell V, Itzhak J Ben, Levinson O, Av-raham Z, et al. 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 2017; 21(6): 2039–44.

Raisingani D, Gupta S, Mital P, Khullar P. Anatomic and diag-nostic challenges of C-shaped root canal system. Int J Clin Pe-diatr Dent 2014; 7(1): 35–9.

Martins JN, Mata A, Marques D, Caramês J. Prevalence of C-shaped mandibular molars in the Portuguese population eval-uated by cone-beam computed tomography. Eur J Dent 2016; 10(4): 529–35.

Helvacioglu-Yigit D, Sinanoglu A. Use of cone-beam computed tomography to evaluate C-shaped root canal systems in man-dibular second molars in a Turkish subpopulation: a retrospec-tive study. Int Endod J 2013; 46(11): 1032–8.

Jin GC, Lee SJ, Roh BD. Anatomical study of C-shaped canals in mandibular second molars by analysis of computed tomog-raphy. J Endod 2006; 32(1): 10–3.

Peiris R, Takahashi M, Sasaki K, Kanazawa E. Root and canal morphology of permanent mandibular molars in a Sri Lankan population. Odontology 2007; 95(1): 16–23.

Neelakantan P, Subbarao C, Subbarao CV, Ravindranath M. Root and canal morphology of mandibular second molars in an In-dian population. J Endod 2010; 36(8): 1319–22.

Al-Fouzan KS. C-shaped root canals in mandibular second mo-lars in a Saudi Arabian population. Int Endod J 2002; 35(6): 499–504.

Lambrianidis T, Lyroudia K, Pandelidou O, Nicolaou A. Evalua-tion of periapical radiographs in the recognition of C-shaped mandibular second molars. Int Endod J 2001; 34(6): 458–62.

Weine FS. The C-shaped mandibular second molar: incidence and other considerations. Members of the Arizona Endodon-tic Association. J Endod 1998; 24(5): 372–5.

Cimilli H, Cimilli T, Mumcu G, Kartal N, Wesselink P. Spiral computed tomographic demonstration of C-shaped canals in mandibular second molars. Dentomaxillofac Radiol 2005; 34(3): 164–7.

Martins JN, Marques D, Mata A, Caramês J. Root and root ca-nal morphology of the permanent dentition in a Caucasian population: a cone-beam computed tomography study. Int Endod J 2017; 50(11): 1013–26.

Yang ZP, Yang SF, Lin YC, Shay JC, Chi CY. C-shaped root canals in mandibular second molars in a Chinese population. Dent Traumatol 1988; 4(4): 160–3.

Jayasinghe RD, Li TKL. C-shaped canals in mandibular second molars in the Hong Kong population: a computed tomograph-ic study. Hong Kong Dent J 2008; 5(1): 27–30.

Seo MS, Park DS. C-shaped root canals of mandibular second molars in a Korean population: clinical observation and in vitro analysis. Int Endod J 2004; 37(2): 139–44.