Evaluation of Root Canal Configuration of Mandibular First Molars among Egyptian Sub Population

Abstract

Root canal morphology differs widely between different populations; this study was conducted to understand different root canal configurations of mandibular first molars among Egyptian population to make the clinicians more familiar with the most common configurations they face during their daily practice. Also to encourage different clinicians to get use of recent advances in the field of endodontics like usage of different ways of magnification (dental loupes, dental operating microscope) to see what they are not able to see with naked eye. Also to get use of advanced radiographic imaging techniques like CBCT to be able to inspect the third dimension (buccolingual) that can’t be seen by two dimensional conventional radiographs and can guide the clinician during searching for extra canals that can endanger the success of the whole root canal treatment procedure if it is missed. The clearing technique enables us to directly see the root canal morphology by rendering it clear and be familiar with its complex inter-canal communication, lateral canals and apical ramification to recognize the great importance of disinfection procedure whether mechanically or chemically. This will lead to better understanding of the complicated system we are dealing with and eventually lead to increase our clinical success rate. Three hundred extracted lower first permanent molars were used in this study, access for these teeth were done followed by troughing of the groove joining the mesiobuccal and mesiolingual orifices and then inspected under good magnification and illumination of DOM. Then these teeth were radiographed using CBCT to reveal the root canal configuration. Finally, these teeth were subjected to clearing procedures and ink was injected in the access cavity where the ink diffused into the root canal system to be able to directly visualize its 3 dimension morphology. Results of this study revealed that the presence of radix entomolaris (extra distolingual root) is rare in the Egyptian population. The mandibular first molars in the Egyptian population mostly have 3 canals; 2 mesial canals and one distal canal followed by 4 canals; 2 mesial canals and 2 distal ones, accessory mesial canal was found in about 18% of the sample.