Cone-beam computed tomography classification of the mandibular second molar root morphology and its relationship to pano
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ORIGINAL ARTICLE
Cone‑beam computed tomography classification of the mandibular second molar root morphology and its relationship to panoramic radiographic appearance Takuma Funakoshi1 · Takuya Shibata1 · Kyoko Inamoto2 · Naoki Shibata2 · Yoshiko Ariji1 · Motoki Fukuda1 · Kazuhiko Nakata2 · Eiichiro Ariji1 Received: 12 July 2020 / Accepted: 11 September 2020 © Japanese Society for Oral and Maxillofacial Radiology and Springer Nature Singapore Pte Ltd. 2020
Abstract Objectives This study aimed to clarify the relationship between the panoramic radiographic appearance and the longitudinal cone-beam computed tomography (CBCT) classification of root configurations of the mandibular second molar. Methods Panoramic radiographs of 1058 mandibular second molars were classified into five types according to the number and configuration of the roots. These molars were also examined with CBCT at four levels between the pulp chamber and the root apex, and axial images perpendicular to the root axis were categorized into three patterns: single (fused root with small grooves on both buccal and lingual sides or a round root with one canal); double (two separate roots with a trabecular appearance between them); and C-shaped (root with a deep groove opening only on the lingual or buccal side relative to the opposite side). Based on these patterns and their scan levels, the CBCT root morphology appearance in each tooth unit was classified into seven groups. Relationships were investigated between these seven CBCT groups and the five panoramic root types. Results In panoramic types 1 and 2 (with separate roots), 85% had roots with a double pattern (groups II and III) on the CBCT images. In panoramic types 3 and 4 (with fused roots), 85% had C-shaped CBCT patterns at the lower scan levels. Conclusions When panoramic images show fused root types, CBCT examinations should be planned to clarify the root canal configuration. Keywords Mandibular second molar · Tooth root · Cone-beam computed tomography · C-shaped root
Introduction Root canal treatment of mandibular second molars is known to be difficult because of their complicated root and canal configurations. The C-shaped canal is one such configuration [1, 2] that is frequently observed, especially in Japanese Takuma Funakoshi and Takuya Shibata contributed equally to this work. * Takuma Funakoshi [email protected] 1
Department of Oral and Maxillofacial Radiology, AichiGakuin University School of Dentistry, 2‑11 Suemori‑dori, Chikusa‑ku, Nagoya 464‑8651, Japan
Department of Endodontics, Aichi-Gakuin University School of Dentistry, 2‑11 Suemori‑dori, Chikusa‑ku, Nagoya 464‑8651, Japan
2
[3, 4], Chinese [5, 6] and Korean [7, 8] populations, which have a prevalence of 30% or more. An essential factor for the success of root canal treatment is clarification of the root canal configuration before treatment [1, 2]. Comprehension of the longitudinal type distribution of C-shaped root canal along the root axis is important for avoiding failure during endodontic treatment of
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