Micro-computed tomography characterisation of the root and canal morphology of mandibular first premolars with deep radicular grooves
Sufficient knowledge of root canals and their complexity and variations is essential in achieving a successful root canal treatment. This study aimed to characterise the root and canal morphology of mandibular first premolars with radicular grooves using micro-CT in the Malaysian population using...
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| Format: | Thesis |
| Language: | English |
| Published: |
2024
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| Subjects: | |
| Online Access: | http://eprints.usm.my/60966/1/MOHMED%20ISAQALI%20KAROBARI-FINAL%20THESIS%20P-SGD001420%28R%29-E.pdf |
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| Summary: | Sufficient knowledge of root canals and their complexity and variations is
essential in achieving a successful root canal treatment. This study aimed to
characterise the root and canal morphology of mandibular first premolars with
radicular grooves using micro-CT in the Malaysian population using a recently
introduced classification system, and visualisation of root canal morphology using
direct, microscope and radiography and determine the application of recently
introduced classification system in education though a survey. The study included
three distinct components: 1) Micro-CT analysis of 133 mandibular first premolars
with deep radicular grooves in the Malaysian subpopulation, assessing deep radicular
groove characteristics, root canal configurations, accessory canals, isthmus
prevalence, and dentinal thickness; 2) Evaluation of the same samples using direct
vision, microscopy, and radiography to compare clinical assessment methods with
micro-CT findings; 3) A survey study undertaken involving 1082 dental students in
Indian dental colleges to gauge their perceptions of applying a recently introduced
classification system. Results showed that radicular grooves were predominantly
located in the distal aspect (59.1%) and mesial aspect (39.8%). The average
measurements for radicular grooves were: CEJ-to-coronal groove distance mean ± SD
(4.92± 1.18 mm), apical groove to root apex distance (2.35 ± 1.56 mm), and groove
length (6.69 ± 1.42 mm). Average depth of the radicular groove was 1.48 ± 0.54 mm,
with variations at different reference levels. Dentinal thickness at the radicular groove
was measured at 0.69±0.26 mm internally and 1.15±0.30 mm externally, with
variations at different reference levels. Multiple root canal configurations were
observed, with the 1MFP1-2 configuration found to be the most common, comprising a
frequency of 19.54% of the observed cases. Accessory canal morphology variations
were diverse, with no accessory canal (18.0%) and a delta (1MFP(D)) (21.8%) being
prevalent. Accessory canals were most located in the apical third (52.29%) and both middle and apical thirds (28.44%). According to Fan et al. (2010) classification, types
2, 3, and 4 isthmuses were observed in varying frequencies. Clinical assessment
methods showed significant differences in observed root canal configurations
compared to micro-CT imaging (P<0.001). Distribution and percentage of radiograph
with micro-CT comparison for examiners 1 and 2 revealed significant differences
between the root canal configurations (P<0.001). Dental students' perceptions of the
recently introduced classification system in Indian dental colleges were surveyed to
assess its practicality and acceptance. Overall, 92.88% and 91.78% of study
participants revealed that the Ahmed et al. (2017) classification system to classify the
root and canal morphology was much more practical and accurate than that of the
Vertucci’s classification system and its additional configurations. In conclusion, the
current study showed significant variations in the location of the radicular grooves
predominantly situated in the distal aspect with the most common root canal
configuration being 1MFP1-2. The most common type of isthmus observed was Type
2. The multiple visualization techniques, including direct vision, microscopy, and
radiography comparisons contributed to a more comprehensive understanding of the
advantages and limitations of each method, which guide clinicians in choosing the
most suitable imaging method for specific cases. In comparison to Vertucci’s
classification system and supplementary types, the undergraduate and postgraduate
dental students, and interns in India agreed that Ahmed et al. (2017) classification
system is more practical and accurate for classifying the root and canal morphology. |
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