Three-Rooted Mandibular First Molars in a Saudi Arabian Population: A CBCT Study

Santosh R Patil, G Maragathavalli, Kazuyuki Araki, Ibrahim A Al-Zoubi, Mohammed G Sghaireen, Ravi Kumar Gudipaneni, Mohammad Khursheed Alam

Abstract


Objective: To know the prevalence three-rooted mandibular first molars in a Saudi Arabian population by using CBCT. Material and Methods: A total of 428 CBCT scans in the database of the College of Dentistry, Jouf University, Kingdom of Saudi Arabia were analyzed. All well-developed permanent mandibular first molars were analyzed for the presence of extra root in three dimensions and the reconstructed volumetric images by two qualified and experienced observers. The total incidence, distribution and comparison regarding gender, bilateral and unilateral appearance, and the side of occurrences of these permanent three-rooted mandibular first molars were analyzed by the Chi-square test. The level of significance was set at 5%. Results: The CBCT scans of 14 subjects had three rooted mandibular first molars with a prevalence of 3.27%. The prevalence in males and females was 2.96% respectively, with no significant differences between genders (p=0.865). The frequency of bilateral three-rooted mandibular first molars was 1.16%, with unilateral frequencies of 1.40% and 0.70% on the right and left sides, respectively. No significant relationship between sides (p=0.981) and the bilateral prevalence of three-rooted mandibular first molars (p=0.668) was observed. Conclusion: Dental practitioners must be aware of the fact that though it is rare, an extra or third root can be present in mandibular first molars and CBCT can aid in accurate diagnosis of the presence of third root.


Keywords


Molar; Tooth Root; Cone-Beam Computed Tomography.

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References


Giuseppe C, Elio B, Arnaldo C. Missed anatomy: frequency and clinical impact. Endod Topics 2009; 15(1):3-31. doi: 10.1111/j.1601-1546.2009.00240.x.

Patil S, Doni B, Rahman F, Kaswan S. Prevalence of dental anomalies in the Indian population. J Clin Exp Dent 2013; 5(4):e183-86. doi: 10.4317/jced.51119.

Nagaven NB, Umashankara KV. Radix entomolaris and paramolaris in children: A review of the literature. J Indian Soc Pedod Prev Dent 2012; 30(2):94-102. doi: 10.4103/0970-4388.99978.

De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: An endodontic challenge. Int Endod J 2004; 37(11):789-99. doi: 10.1111/j.1365-2591.2004.00870.x.

Patil SR, Ghani HA, Almuhaiza M, Al-Zoubi IA, Anil KN, Misra N, Raghuram PH. Prevalence of pulp stones in a Saudi Arabian subpopulation: A cone-beam computed tomography study. Saudi Endod J 2018; 8(2):93-8. doi: 10.4103/sej.sej_32_17.

Patil SR, Araki K, Ghani HA, Al-Zoubi IA, Sghaireen MG, Gudipaneni RK, et al. A cone beam computed tomography study of the prevalence of pulp stones in a Saudi Arabian adolescent population. Pesq Bras Odontoped Clin Integr 2018; 18(1):e3973. doi: 10.4034/PBOCI.2018.181.45.

Sinha N, Singh B, Patil S. Cone beam computed topographic evaluation of a central incisor with an open apex and a failed root canal treatment using one-step apexification with Biodentineâ„¢: A case report. J Conserv Dent 2014; 17(3):285-9. doi: 10.4103/0972-0707.131805.

Al-Zoubi IA, Patil SR, Takeuchi K, Misra N, Ohno Y, Sugita Y, Maeda H, Alam MK. Analysis of the length and types of root trunk and length of root in human first and second molars and to the actual measurements with the 3D CBCT. J Hard Tissue Biol 2018; 27(1):39-42. doi: 10.2485/jhtb.27.39.

Alam MK, Alhabib S, Alzarea BK, Irshad M, Faruqi S, Sghaireen MG, et al. 3D CBCT morphometric assessment of mental foramen in Arabic population and global comparison: imperative for invasive and non-invasive procedures in mandible. Acta Odontol Scand 2018; 76(2):98-104. doi: 10.1080/00016357.2017.1387813.

Younes SA, Al-Shammery AR, El-Angbawi AF. Three-rotoed permanent mandibular first molars of Asian and black groups in the Middle East. Oral Surg Oral Med Oral Pathol 1990; 69(1):102-5. doi: 10.1016/0030-4220(90)90276-X.

Al-Nazhan S. Incidence of four canals in root-canal-treated mandibular first molars in a Saudi Arabian sub-population. Int Endod J 1999; 32(1):49-52. doi: 10.1046/j.1365-2591.1999.00188.x.

Patil SR, Alam MK, Moriyama K, Matsuda S, Shoumura M, Osuga N. 3D CBCT Assessment of soft tissue calcification. J Hard Tissue Biol 2017; 26(3):297-300. doi: 10.2485/jhtb.26.297.

Al-Zoubi IA, Patil SR, Kato I, Sugita Y, Maeda H, MK. 3D CBCT Assessment of incidental maxillary sinus abnormalities in a Saudi Arabian population. J Hard Tissue Biol 2017; 26(4):369-372.

Patil SR, Araki K, Yadav N, Ghani HA. Prevalence of hypercementosis in a Saudi Arabian population: A cone beam computed tomography study. J Oral Res 2018; 7(3):94-97. doi: 10.2485/jhtb.26.369.

Rahimi S, Mokhtari H, Ranjkesh B, Johari M, Frough Reyhani M, Shahi SH, et al. Prevalence of extra roots in permanent mandibular first molars in Iranian population: A CBCT analysis. Iran Endod J 2017; 12(1):70-3. doi: 10.22037/iej.2017.14.

Tu MG, Huang HL, Hsue SS, Hsu JT, Chen SY, Jou MJ, Tsai CC. Detection of permanent three-rooted mandibular first molars by cone-beam computed tomography imaging in Taiwanese individuals. J Endod 2009; 35(4):503-7. doi: 10.1016/j.joen.2008.12.013.

Zhang R, Wang H, Tian YY, Yu X, Hu T, Dummer PM. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular molars in Chinese individuals. Int Endod J 2011; 44(11):990-9. doi: 10.1111/j.1365-2591.2011.01904.x.

Demirbuga S, Sekerci AE, Dinçer AN, Cayabatmaz M, Zorba YO. Use of cone-beam computed tomography to evaluate root and canal morphology of mandibular first and second molars in Turkish individuals. Med Oral Patol Oral Cir Bucal 2013; 18(4):e737-e744. doi: 10.4317/medoral.18473.

Shemesh A, Levin A, Katzenell V, Ben Itzhak J, Levinson O, Zini A, et al. Prevalence of 3- and 4-rooted first and second mandibular molars in the Israeli population. J Endod 2015; 41(3):338-42. doi: 10.1016/j.joen.2014.11.006.

Rodrigues CT, de Oliveira-Santos C, Bernardineli N, et al. Prevalence and morphometric analysis of three-rooted mandibular first molars in a Brazilian subpopulation. J Appl Oral Sci 2016; 24(5):535-42. doi: 10.1590/1678-775720150511.

Gulabivala K, Aung TH, Alavi A, Ng YL. Root and canal morphology of Burmese mandibular molars. Int Endod J 2001; 34(5):359-70. doi: 10.1046/j.1365-2591.2001.00399.x.

Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. Int Endod J 2002; 35(1):56-62. doi: 10.1046/j.1365-2591.2002.00452.x.

Peiris R, Takahashi M, Sasaki K, Kanazawa E. Root and canal morphology of permanent mandibular molars in Sri Lankan population. Odontology 2007; 95(1):16-23. doi: 1 10.1007/s10266-007-0074-8.

Huang RY, Lin CD, Lee MS, Yeh CL, Shen EC, Chiang CY, Chiu HC, Fu E. Mandibular disto-lingual root: A consideration in periodontal therapy. J Periodontol 2007; 78(8):1485-90. doi: 10.1902/jop.2007.060419.

Tu MG, Tsai CC, Jou MJ, Chen WL, Chang YF, Chen SY, Cheng HW. Prevalence of three-rooted mandibular first molars among Taiwanese individuals. J Endod 2007; 33(10):1163-6. doi: 10.1016/j.joen.2007.07.020.

Schafer E, Breuer D, Janzen S. The prevalence of three-rooted mandibular permanent first molars in a German population. J Endod 2009; 35(2):202-5. doi: 10.1016/j.joen.2008.11.010.

Tu MG, Liu JF, Dai PW, Chen SY, Hsu JT, Huang H. Prevalence of three-rooted primary mandibular first molars in Taiwan. J Formos Med Assoc 2010; 109(1):69-74. doi: 10.1016/S0929-6646(10)60023-X.

Liu JF, Dai PW, Chen SY, Huang HL, Hsu JT, Chen WL, Tu MG. Prevalence of 3-rooted primary mandibular second molars among Chinese patients. Pediatr Dent 2010; 32(2):123-6.

Garg AK, Tewari RK, Kumar A, Hashmi SH, Agrawal N, Mishra SK. Prevalence of three-rooted mandibular permanent first molars among the Indian population. J Endod 2010; 36(8):1302-6. doi: 10.1016/j.joen.2010.04.019.

Song JS, Choi HJ, Jung IY, Jung HS, Kim SO. The prevalence and morphologic classification of distolingual roots in the mandibular molars in a Korean population. J Endod 2010; 36(4):653-7. doi: 10.1016/j.joen.2009.10.007.

Yang Y, Zhang LD, Ge JP, Zhu YQ. Prevalence of 3-rooted first permanent molars among a Shanghai Chinese population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110(5):e98-100. doi: 10.1016/j.tripleo.2010.05.068.

Huang RY, Cheng WC, Chen CJ, Lin CD, Lai TM, Shen EC, et al. Three-dimensional analysis of the root morphology of mandibular first molars with distolingual roots. Int Endod J 2010; 43(6):478-84. doi: 10.1111/j.1365-2591.2010.01702.x.

Colak H, Ozcan E, Hamidi MM. Prevalence of three-rooted mandibular permanent first molars among the Turkish population. Niger J Clin Pract. 2012; 15(3):306-10. doi: 10.4103/1119-3077.100627.

Garg AK, Tewari RK, Agrawal N. Prevalence of three-rooted mandibular first molars among Indians using SCT. Int J Dent 2013; 2013:183869. doi: 10.1155/2013/183869.

Loh HS. Incidence and features of three-rooted permanent mandibular molars. Aust Dent J 1990; 35(5):434-7. doi: 10.1111/j.1834-7819.1990.tb05426.x.

Walker RT, Quackenbush LE. Three-rooted lower first permanent molars in Hong Kong Chinese. Br Dent J 1985; 159(9):298-9.

de Souza-Freitas JA, Lopes ES, Casati-Alvares L. Anatomic variations of lower first permanent molar roots in two ethnic groups. Oral Surg Oral Med Oral Pathol 1971;31(2):274-8.




DOI: http://dx.doi.org/10.4034/PBOCI.2018.181.87

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