Assessment of the Prevalence of Middle Mesial Canal in Mandibular First Molar: A Multinational Cross-sectional Study with Meta-analysis

Pertek Hatipoğlu F 1 , Mağat G 2 , Hatipoğlu Ö 3 , Taha N 4 , Alfirjani S 5 , Abidin IZ 6 Show all authors , Lehmann AP 7 , Alkhawas MAM 8 , Buchanan GD 9 , Kopbayeva M 10 , Surendar S 11 , Javed MQ 12 , Madfa AA 13 , Donnermeyer D 14 , Krmek SJ 15 , Bhatti UA 16 , Palma PJ 17 , Brochado Martins JF 18

Affiliations 

  • 1 Department of Endodontics, Nigde Omer Halisdemir University, Niğde, Turkey
  • 2 Department of Oral Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
  • 3 Department of Restorative Dentistry, Nigde Omer Halisdemir University, Niğde, Turkey. Electronic address: ohatipoglu@ohu.edu.tr
  • 4 Department of Conservative Dentistry, Jordan University of science and Technology Irbid, Jordan
  • 5 Department of Conservative Dentistry and Endodontics, University of Benghazi, Benghazi, Libya
  • 6 International Islamic University Malaysia (IIUM), Kuala Lumpur, Malaysia
  • 7 Poznań University of Medical Sciences Dept. of Conservative Dentistry and Endodontics Poznań, Poznań, Poland
  • 8 Professor and Head of Endodontic Department, Al-Azhar University, Cairo, Egypt
  • 9 Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
  • 10 Kazakh National Medical University Asfendiyarov, Almaty, Kazakhstan
  • 11 Department of Conservative Dentistry and Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
  • 12 Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
  • 13 Department of Restorative Dental Science, Collage of Dentistry, University of Ha'il, Ha'il, Saudi Arabia; Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, Yemen
  • 14 Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Münster, Germany
  • 15 Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
  • 16 Department of Operative Dentistry and Endodontics, Riphah International University, Pakistan
  • 17 Center for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, Portugal; Institute of Endodontics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
  • 18 Department of Endodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
J Endod, 2023 Mar 01.
PMID: 36863567 DOI: 10.1016/j.joen.2023.02.012

Abstract

BACKGROUND: An additional canal found in the mandibular first molar (M1M) is the middle mesial canal (MMC), which is often missed during root canal treatment. In this study, the prevalence of MMC in M1M on cone-beam computed tomography (CBCT) images was evaluated in 15 countries, along with the effect of some demographic factors on its prevalence.

METHODS: Deidentified CBCT images were scanned retrospectively, and the ones including bilateral M1Ms were included in the study. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating three planes (coronal, sagittal, and axial) after a 3-dimensional alignment of the long axis of the root(s). The presence of an MMC in M1Ms (yes/no) was identified and recorded.

RESULTS: In total, 6304 CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries (P  .05) or between genders (odds ratio= 1.07, 95% CI: 0.91, 1.27; P > .05). As for the age groups, no significant differences were found (P > .05).

CONCLUSIONS: The prevalence of MMC varies by ethnicity, but it is generally estimated at 7% worldwide. Physicians must pay close attention to the presence of MMC in M1M, especially for opposite M1Ms, due to the prevalence of MMC being significantly bilateral.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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