Home Current issue Instructions
About us Archives Login 
Editorial board Search articles Contact us
Home Print this page Email this page Users Online: 686

 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 2  |  Page : 84-89

Analysis of root and canal morphology of maxillary first and second molars among malay ethnic in the malaysian population with the aid of cone-beam computed tomography: A retrospective study


1 Conservative Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia; Hospital Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
2 Hospital Universiti Sains Malaysia; Forensic Odontology and Oral Biology Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia

Date of Submission21-Sep-2019
Date of Acceptance15-Jan-2020
Date of Web Publication29-Apr-2020

Correspondence Address:
Dr. Huwaina Abd Ghani
School of Dental Sciences, Universiti Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan
Malaysia
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ejgd.ejgd_167_19

Rights and Permissions
  Abstract 


Aim: This study aimed to investigate the root and canal morphology of permanent maxillary first and second molars using cone-beam computed tomography (CBCT) imaging. Materials and Methods: This study evaluated the CBCT images of 480 maxillary first molars and 536 maxillary second molars from 268 patients who received CBCT scanning for various procedures. The number of roots, prevalence of the second mesiobuccal (MB2) canal in the mesiobuccal root, its association with gender, and the prevalence of bilateral MB2 canals were evaluated. Descriptive statistics was used to evaluate the prevalence, while Chi-square test was used to assess the association between the prevalence of MB2 canal and gender with a significance level set atP < 0.05 and P < 0.001. Results: Majority of maxillary first (97.7%) and second molars (80.0%) were presented with three roots. MB2 canals were found in 59.9% and 35.2% of maxillary first and second molars, respectively. The prevalence of MB2 canals among male patients was significantly higher in both maxillary first (P< 0.05) and second molars (P< 0.001). Bilateral MB2 canals were seen in 76.2% and 58.3% of maxillary first and second molars, respectively. Conclusions: MB2 canal was common among Malay ethnic with the prevalence of approximately 60% and 35% in maxillary first and second molars, respectively. Our findings will increase the knowledge and awareness of dental clinicians to be more vigilant in identifying the MB2 canal to ensure complete cleaning and obturation of all root canals during root canal treatment.

Keywords: Cone-beam computed tomography, Malay, maxillary first molar, maxillary second molar, root and canal morphology


How to cite this article:
Abd Rahman N, Halim MS, Khamis MF, Abd Ghani H. Analysis of root and canal morphology of maxillary first and second molars among malay ethnic in the malaysian population with the aid of cone-beam computed tomography: A retrospective study. Eur J Gen Dent 2020;9:84-9

How to cite this URL:
Abd Rahman N, Halim MS, Khamis MF, Abd Ghani H. Analysis of root and canal morphology of maxillary first and second molars among malay ethnic in the malaysian population with the aid of cone-beam computed tomography: A retrospective study. Eur J Gen Dent [serial online] 2020 [cited 2020 Jun 3];9:84-9. Available from: http://www.ejgd.org/text.asp?2020/9/2/84/283480




  Introduction Top


Root and canal morphology knowledge determines the success of root canal treatment (RCT). Majority of failures in RCT resulted from missed second mesiobuccal (MB2) canals in maxillary first and second molars.[1],[2],[3],[4],[5]Cone-beam computed tomography (CBCT) has been extensively used to study root and canal morphology due to its noninvasiveness, high resolution, and accuracy.[6],[7]Due to the lack of standard data, this study aimed to evaluate root canal morphology of maxillary first and second molars among Malay ethnic within the Malaysian population using CBCT imaging with specific objectives of evaluating the number of roots, the prevalence of MB2 canal, its association with gender, and the prevalence of bilateral MB2 canals.


  Materials and Methods Top


This is a retrospective cross-sectional study utilizing CBCT scans to determine the prevalence of MB2 canals in permanent maxillary first and second molar teeth among patients attending the dental clinic in the School of Dental Sciences of Universiti Sains Malaysia. Ethics approval was obtained from the Human Research Ethics Committee of Universiti Sains Malaysia, Malaysia, with the reference number of USM/JEPeM/18010034), and the sample size of 260 patients was found to be adequate to estimate the prevalence to an accuracy within 10% (0.1). A total of 2225 CBCT scans (from January 1, 2010, to December 31, 2018) were examined for the inclusion criteria. Two hundred and sixty-eight consecutive cases, representing 137 female and 131 male patients, which met the criteria, were included in this study. The average patient age was 37 years (ranging from 14 to 69 years). The inclusion criteria were defined as follows: Malay ethnic, age: 14–69 years old, fully mature apices, and intact roots. In contrast, the exclusion criteria were defined as follows: the presence of periapical periodontitis, root canal treated tooth, posts or crown restorations, canal calcification, external or internal root resorption, caries that reach the trifurcation area, and low-quality images or interference of artifacts.

The CBCT images were previously obtained using three-dimensional Planmeca Promax (Finland) with the following parameters: 90 kVp, 10 mA, a field of view 80 mm × 80 mm, voxel size 320 μm, and dosage of 1233 DAP (mGy × cm2). Axial, coronal, and sagittal two-dimensional sections of the chosen images were displayed on a monitor (Dell SE2717H 27-inch Full HD LED-Lit, 1920 × 1080 resolution, Dell Inc., Texas, United States) and were inspected using Romexis 2.9.2 viewer software (Planmeca USA, Inc.). Reformatted images were magnified by 180% and were analyzed with a slice thickness of 0.25 mm for a clear radiographic evaluation of the root canal morphology in the maxillary first and second molars. The number of root canal from the coronal third to the apical third of each root was observed according to the Vertucci's classification with modifications.[7],[8]The prevalence of bilateral MB2 canals in the mesiobuccal (MB) roots of maxillary first and second molars was calculated.

The examiners performed intra- and interexaminer calibrations based on the anatomic diagnosis of CBCT images, and the kappa statistic was used to test data reliability. An endodontist and an investigator analyzed 10 randomly selected CBCT images of morphologically diverse maxillary molars. The images were assessed twice by both the examiners, with a 1-week interval between the evaluations. The measure of agreement based on Cohen's kappa for intra- and interexaminer calibrations was almost perfect (1.00) and strong (0.82), respectively.[9]SPSS software (IBM® SPSS® Statistics version 24, Chicago, USA) was used to perform descriptive and statistical analyses. Descriptive data were reported in the form of frequency and percentage. Chi-square test was used to compare the prevalence of MB2 canal in maxillary second molar MB root between the gender and tooth side with a significance level set at P< 0.05 and P< 0.001.


  Results Top


Number of roots and morphology

The number of roots in each of the 480 maxillary first molars and 536 s molars was determined [Table 1]. The prevalence of three-rooted first molars was 469 (97.7%), and in second molars, it was 429 (80.0%). None of the first molars had four roots, while only 2 (0.4%) of the second molars had four roots, which consisted of three buccal roots and one palatal root. The extra buccal roots had no detectible canal. There was more morphological variation, particularly the fusion of roots, in the second molars than in the first molars. The prevalence of two-rooted first molars was 11 (2.3%). Among these two-rooted first molars, seven teeth were presented with separate buccal and palatal roots, while four teeth were presented with mesial and distal roots. On the other hand, 26 (4.9%) single root and 79 (14.7%) two roots were detected in second molars. Among the second molars with two roots, 60 teeth were presented with separate buccal and palatal roots and another 19 teeth had mesial and distal roots.
Table 1: Frequency distribution of root number according to the tooth position

Click here to view


Number of canals and morphology

The distribution frequency of canal configurations in the maxillary first and second molars was evaluated [Table 2], [Table 3], [Table 4]. The number and frequency of MB2 canals were presented in the MB roots of three-rooted first and second molars by 59.9% and 35.2%, respectively [Table 2]. The most common canal configuration in the MB roots of three-rooted first and second molars was Type I, followed by Type IV and Type II [Table 3] and [Table 4]. In the first molar and second molar of distobuccal roots, Type I canal configuration was the most common with only two (1 first and 1 second molar) had Type IV canal configuration. Meanwhile, the palatal (Pa) roots of three-rooted first and second molars were presented with Type I canal configuration (100%).
Table 2: The number and frequency of mesiobuccal canal in the mesiobuccal root of three-rooted maxillary first and second molars

Click here to view
Table 3: Configuration of root canal systems in maxillary first molars (n=480)

Click here to view
Table 4: Configuration of root canal systems in maxillary second molars (n=536)

Click here to view


In the buccal roots of two-rooted first molars, the most common canal configuration was Type I (28.6%), Type II (28.6%), and Type IV (28.6%). The Pa roots of two-rooted first molars had Type I (85.8%) and Type II (14.2%) canal configurations. In two-rooted first molars with mesial and distal roots, the most prevalent canal configuration was Type I (25.0% and 75.0%, respectively). The most common canal configuration in the buccal roots of two-rooted second molars was Type I (51.7%), Type II (30.0%), and followed by Type IV (6.6%). The Pa roots of two-rooted second molars had only type I (100.0%) canal configuration. Two-rooted second molars with mesial and distal roots had Type IV (89.5%) and Type I (100.0%), respectively, as the most prevalent canal configurations. In this study, single-rooted maxillary second molar teeth were more frequently presented with additional Type 3–2 (26.9%) followed with Type I (23.1%).

Association of the second mesiobuccal canal with gender and tooth side

There was an association between male and the prevalence of the MB2 canals in both maxillary first (P< 0.05) and second molars (P< 0.001) [Table 5]. Therefore, the null hypothesis was rejected. The prevalence of MB2 canals in the maxillary first molars of male patients was 65.3%, while in female patients, it was only 54.0%. Likewise, the prevalence of MB2 canals in the maxillary second molars of male patients was also higher (43.5%) compared to female patients (24.7%). In contrast, there was no significant difference in the prevalence of MB2 canals between the tooth side in either first or second molars (P>0.05) [Table 5]. The bilateral occurrence of MB2 canals in the MB roots of maxillary first and second molars was presented in 112 (76.2%) and 57 (58.3%) patients, respectively [Table 6].
Table 5: The number and frequency of the second mesiobuccal canal in the mesiobuccal root of three-rooted maxillary first molars by gender and tooth side

Click here to view
Table 6: Unilateral and bilateral occurrence of the second mesiobuccal canals in the mesiobuccal roots of three-rooted maxillary first and second molars

Click here to view



  Discussion Top


The study of root and canal morphology possesses endodontic and anthropological significance.[10],[11]Interestingly, root and canal morphology varies greatly among different populations and even among different individuals from the same population. Furthermore, root and canal morphology is an important factor to consider in RCT because the success rate heavily depends on identification, adequate cleaning, and complete obturation of all root canals. For instance, if two separate canals join together into one canal at a distant length from the apex, the treatment of only one canal may suffice to yield success with a low chance of failure.[12]However, if the canals are joined together near the apex or exit as two separate foramina, the failure rate to debride both the canals will be higher because the remaining microorganisms and organic debris are close to the apical foramen.[13],[14]Therefore, every clinician should fully understand the anatomical complexities of the root canal system to provide an effective root canal debridement.

Previousin vitrostudies of root and canal morphology generally involved extracted teeth using various methods such as magnification with microscope, sectioning, clearing and staining, conventional radiograph, and micro-computed tomography to allow direct observation of the root canal systems although time consuming, tedious, and limited sample size.[14],[15],[16],[17],[18],[19],[20]Recently, more studies have been utilizing CBCT as a method to study root and canal morphology.[6],[21],[22],[23],[24],[25],[26],[27],[28],[29],[30],[31]CBCT imaging is more accurate, effective, and reliable as a diagnostic tool compared to other imaging modalities and conventional methods.[23],[32]For clinical settings, the American Association of Endodontics and American Academy of Oral and Maxillofacial Radiology recently came up with a comprehensive guideline regarding the use of CBCT imaging in endodontics for the initial assessment of teeth with suspected additional canals and complex anatomy.[4]However, clinicians should not use CBCT imaging routinely unless indicated because it has higher radiation exposure and more expensive compared to an intraoral radiograph.[2],[6]

Using similar imaging methods, Al-Kadhim et al.reported that 98% of maxillary first molars have three separate roots, which is almost identical to our finding (97.7%).[21]Our result is also consistent with a study from our neighboring country, Thailand, which found that 99.8% of first molars and 87.1% of second molars have three roots.[6]However, we found a slight anatomical variation of maxillary first and second molars in Malay ethnic. The presence of two roots was observed in both maxillary first molars (2.3%) and second molars (14.7%). In contrast, Ratanajirasut et al.did not find any maxillary first molar with two roots, while it was observed in 9.2% of their second molars.[6]It can be concluded that Malay ethnic showed a higher occurrence of root fusion in both maxillary molars compared to the Thailand population. This difference highlights the influence of ethnic background on maxillary molars root morphology. Maxillary second molars showed a greater variation in root numbers and morphology compared to the first molars. Single-, two-, and four-rooted teeth were found in many previous studies, which are consistent with our findings.[6],[15],[16],[19],[26],[28],[29],[31],[33]

In our study, the prevalence of MB2 canal in three-rooted maxillary first and second molars was 59.9% and 35.2%, respectively. Our prevalence of MB2 canal in the first molars was slightly higher than Al-Kadhim et al.(45.6%).[21]This difference could be due to our inclusion criteria of only Malay ethnic, instead of including Chinese and Indians ethnic. Hence, our finding was descriptive of a single ethnic, instead of the general population. Otherwise, our results are generally consistent with the findings from other studies involving Asian populations, namely Thai, Korean, Chinese, Burmese, Indian, and Japanese [Table 7]. These populations showed a similar prevalence of MB2 canals in the first molars, which was in the range of 46.0%-69.0%.[3],[6],[14],[15],[16],[20],[26],[27],[28],[29],[31],[33],[34],[35],[36]On the other hand, the prevalence of the MB2 canal in the second molars has a lower and wider range than the first molars, which is from 7.0% to 55.0%.[3],[6],[15],[16],[26],[27],[29],[31],[33],[35]
Table 7: Literature review comparison of the incidence of the second mesiobuccal canal among the Asian populations

Click here to view


It was found that Type IV is the most common canal configuration, followed by Type II, in the MB roots of maxillary first and second molars. This is consistent with previous studies recorded that Type IV was the most prevalent canal configuration in the first molar MB roots.[3],[14],[15],[16],[26],[31]In the second molar MB roots, both Type II and Type IV were more prevalent.[3],[15],[16],[26],[31]Type IV MB canal in the first molar is quite common among Asian populations, which is contrast to the studies among Caucasians in the United States where Type II canals were more frequently observed.[18]

Our results show an association between gender and the prevalence of the MB2 canal in the MB root of three-rooted maxillary first and second molars. Male patients have a significantly higher prevalence of MB2 canals in both first and second molars than females. However, there have been inconsistent findings on the correlation between gender and prevalence of MB2 canal in maxillary molars in other studies.[4],[6],[21],[26],[28],[29],[31]Therefore, a definite relationship between these two variables has yet to be confirmed and established.

There were a few limitations in our study which could be improved by future studies. Due to the large sample size, our subjects were collected through a convenience sampling method; thus, the prevalence may not represent the whole population of Malay ethnic. Future studies should incorporate a random sampling method for a more accurate prevalence that represents the whole population of interest. Moreover, this was a cross-sectional study in which the data were collected from a population at only one specific point of time, during which different individuals with similar characteristics were compared. A longitudinal study in which a group of subjects are observed over time may have more power than ours, as a longitudinal study can help to establish causal factors, such as age and association with gender. However, a longitudinal study is expensive and time consuming. Furthermore, the patients will receive a higher dose of radiation over the course of the study.

Maxillary first and second molars commonly had three roots; although the second molars were more likely to have variations in the number of roots. MB2 canals were commonly presented as Type IV canal configuration. Male gender was associated with a significantly higher prevalence of MB2 canals in the maxillary first and second molars. Most of the MB2 canals were bilaterally symmetrical. Our findings are beneficial for the clinicians as the high prevalence of the MB2 canal in maxillary molars will justify additional investigations to search for it during access cavity preparation. Therefore, this information helps the clinicians to be more vigilant in identification, cleaning, and obturation of all canals, which can improve the outcome of the treatment.


  Conclusion Top


Obtaining these prevalence data is crucial because failure to recognize the presence of additional root canals during RCT may lead to inadequate removal of infected pulpal tissue and incomplete obturation of all root canals which eventually results in failure of the whole treatment.

Acknowledgment

The authors would like to thank the Management of the Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, for granting permission to the investigators to use patients' medical records; space and assets belong to the hospital during the process of conducting the research and also they express their special thanks to Mr. Firdaus Daud, License Radiologist, School of Dental Sciences, USM.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Betancourt P, Navarro P, Muñoz G, Fuentes R. Prevalence and location of the secondary mesiobuccal canal in 1,100 maxillary molars using cone beam computed tomography. BMC Med Imaging 2016;16:66.  Back to cited text no. 1
    
2.
Witherspoon DE, Small JC, Regan JD. Missed canal systems are the most likely basis for endodontic retreatment of molars. Tex Dent J 2013;130:127-39.  Back to cited text no. 2
    
3.
Kim Y, Lee SJ, Woo J. Morphology of maxillary first and second molars analyzed by cone-beam computed tomography in a korean population: Variations in the number of roots and canals and the incidence of fusion. J Endod 2012;38:1063-8.  Back to cited text no. 3
    
4.
Special Committee to Revise the Joint AAE/AAOMR Position Statement on use of CBCT in Endodontics. AAE and AAOMR Joint Position Statement: Use of Cone Beam Computed Tomography in Endodontics 2015 Update. Oral Surg Oral Med Oral Pathol Oral Radiol 2015;120:508-12.  Back to cited text no. 4
    
5.
Witherspoon DE, Small JC, Regan JD. Missed canal systems are the most likely basis for endodontic retreatment of molars. Tex Dent J 2013;130:127-39.  Back to cited text no. 5
    
6.
Ratanajirasut R, Panichuttra A, Panmekiate S. A cone-beam computed tomographic study of root and canal morphology of maxillary first and second permanent molars in a Thai population. J Endod 2018;44:56-61.  Back to cited text no. 6
    
7.
Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984;58:589-99.  Back to cited text no. 7
    
8.
Kim SY, Kim BS, Woo J, Kim Y. 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 2013;39:1516-21.  Back to cited text no. 8
    
9.
McHugh ML. Interrater reliability: The kappa statistic. Biochem Med (Zagreb) 2012;22:276-82.  Back to cited text no. 9
    
10.
Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. Int Endod J 2002;35:56-62.  Back to cited text no. 10
    
11.
Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod 2004;30:391-8.  Back to cited text no. 11
    
12.
Weine FS, Healey HJ, Gerstein H, Evanson L. Canal configuration in the mesiobuccal root of the maxillary first molar and its endodontic significance. 1969. J Endod 2012;38:1305-8.  Back to cited text no. 12
    
13.
Imura N, Hata GI, Toda T, Otani SM, Fagundes MI. Two canals in mesiobuccal roots of maxillary molars. Int Endod J 1998;31:410-4.  Back to cited text no. 13
    
14.
Weine FS, Hayami S, Hata G, Toda T. Canal configuration of the mesiobuccal root of the maxillary first molar of a Japanese sub-population. Int Endod J 1999;32:79-87.  Back to cited text no. 14
    
15.
Alavi AM, Opasanon A, Ng YL, Gulabivala K. Root and canal morphology of Thai maxillary molars. Int Endod J 2002;35:478-85.  Back to cited text no. 15
    
16.
Ng YL, Aung TH, Alavi A, Gulabivala K. Root and canal morphology of Burmese maxillary molars. Int Endod J 2001;34:620-30.  Back to cited text no. 16
    
17.
Sempira HN, Hartwell GR. Frequency of second mesiobuccal canals in maxillary molars as determined by use of an operating microscope: A clinical study. J Endod 2000;26:673-4.  Back to cited text no. 17
    
18.
Thomas RP, Moule AJ, Bryant R. Root canal morphology of maxillary permanent first molar teeth at various ages. Int Endod J 1993;26:257-67.  Back to cited text no. 18
    
19.
Wolf TG, Paqué F, Woop AC, Willershausen B, Briseño-Marroquín B. Root canal morphology and configuration of 123 maxillary second molars by means of micro-CT. Int J Oral Sci 2017;9:33-7.  Back to cited text no. 19
    
20.
Yamada M, Ide Y, Matsunaga S, Kato H, Nakagawa K. Three-dimensional analysis of mesiobuccal root canal of Japanese maxillary first molar using Micro-CT. Bull Tokyo Dent Coll 2011;52:77-84.  Back to cited text no. 20
    
21.
Al-Kadhim AH, Rajion ZA, Malik NA, Bin Jaafar A. Morphology of maxillary first molars analyzed by cone-beam computed tomography among malaysian: Variations in the number of roots and canals and the incidence of fusion. Int Med J Malays 2017;16:2:33-9.  Back to cited text no. 21
    
22.
Al-Shehri S, Al-Nazhan S, Shoukry S, Al-Shwaimi E, Al-Shemmery B. Root and canal configuration of the maxillary first molar in a Saudi subpopulation: A cone-beam computed tomography study. Saudi Endod J 2017;7:69.  Back to cited text no. 22
  [Full text]  
23.
Blattner TC, George N, Lee CC, Kumar V, Yelton CD. Efficacy of cone-beam computed tomography as a modality to accurately identify the presence of second mesiobuccal canals in maxillary first and second molars: A pilot study. J Endod 2010;36:867-70.  Back to cited text no. 23
    
24.
Deng PU, Halim MS, Masudi SM, Al-Shehadat S, Ahmad B. Cone-beam computed tomography analysis on root and canal morphology of mandibular first permanent molar among multiracial population in East Coast Malaysian population. Eur J Dent 2018;12:410-6.  Back to cited text no. 24
[PUBMED]  [Full text]  
25.
Domark JD, Hatton JF, Benison RP, Hildebolt CF. An ex vivocomparison of digital radiography and cone-beam and micro computed tomography in the detection of the number of canals in the mesiobuccal roots of maxillary molars. J Endod 2013;39:901-5.  Back to cited text no. 25
    
26.
Lee JH, Kim KD, Lee JK, Park W, Jeong JS, Lee Y, et al. Mesiobuccal root canal anatomy of Korean maxillary first and second molars by cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:785-91.  Back to cited text no. 26
    
27.
Lin YH, Lin HN, Chen CC, Chen MS. Evaluation of the root and canal systems of maxillary molars in Taiwanese patients: A cone beam computed tomography study. Biomed J 2017;40:232-8.  Back to cited text no. 27
    
28.
Mohan RP, Thomas MS, Shetty N, Ahmed J, Pallippurath G, Tallada AK. Evaluation of the root and canal morphology of maxillary first and second molar using cone beam computed tomography: A retrospective study. World J Dent 2017;8:134-8.  Back to cited text no. 28
    
29.
Neelakantan P, Subbarao C, Ahuja R, Subbarao CV, Gutmann JL. Cone-beam computed tomography study of root and canal morphology of maxillary first and second molars in an Indian population. J Endod 2010;36:1622-7.  Back to cited text no. 29
    
30.
Plotino G, Tocci L, Grande NM, Testarelli L, Messineo D, Ciotti M, et al. Symmetry of root and root canal morphology of maxillary and mandibular molars in a white population: A cone-beam computed tomography study in vivo. J Endod 2013;39:1545-8.  Back to cited text no. 30
    
31.
Tian XM, Yang XW, Qian L, Wei B, Gong Y. Analysis of the root and canal morphologies in maxillary first and second molars in a Chinese population using cone-beam computed tomography. J Endod 2016;42:696-701.  Back to cited text no. 31
    
32.
Matherne RP, Angelopoulos C, Kulild JC, Tira D. Use of cone-beam computed tomography to identify root canal systems in vitro. J Endod 2008;34:87-9.  Back to cited text no. 32
    
33.
Singh S, Pawar M. Root canal morphology of South Asian Indian maxillary molar teeth. Eur J Dent 2015;9:133-44.  Back to cited text no. 33
[PUBMED]  [Full text]  
34.
Peeters HH, Suardita K, Setijanto D. Prevalence of a second canal in the mesiobuccal root of permanent maxillary first molars from an Indonesian population. J Oral Sci 2011;53:489-94.  Back to cited text no. 34
    
35.
Zhang R, Yang H, Yu X, Wang H, Hu T, Dummer PM. Use of CBCT to identify the morphology of maxillary permanent molar teeth in a Chinese subpopulation. Int Endod J 2011;44:162-9.  Back to cited text no. 35
    
36.
Zheng QH, Wang Y, Zhou XD, Wang Q, Zheng GN, Huang DM. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. J Endod 2010;36:1480-4.  Back to cited text no. 36
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
Abstract
Introduction
Materials and Me...
Results
Discussion
Conclusion
References
Article Tables

 Article Access Statistics
    Viewed154    
    Printed8    
    Emailed0    
    PDF Downloaded43    
    Comments [Add]    

Recommend this journal