Prevalence & Location of Mid Mesial Canal Based on Interorifice Distance Between MB-Ml Canals in Permanent Mandibular 1st, 2nd Molars In West Bengal Population – “A Cone Beam Computed Tomography Study”
"Prevalence & Location of Mid Mesial Canal in Mandibular Molars: A CBCT Study in West Bengal"
Keywords:
Cone beam computed tomography (CBCT), mid mesial canal (MMC), Inter-orifice distance (IOD), mesiocentral canal, third mesial canal.
Abstract
Background Effective endodontic therapy necessitates thorough knowledge of pulp anatomy for proper root canal treatment. Missed canals, particularly middle mesial canals (mmc), are a primary cause of therapy failure and apical periodontitis. AimTo assess the prevalence of MMC and predict its presence based on the inter-orifice distance (IOD) between the mesiobuccal (MB) and mesiolingual (ML) canals in mandibular first and second molars.
Materials and Methods
This retrospective study used CBCT scans selected by specific inclusion criteria and classified MMCs per Pomeranz et al. The data was analysed employing descriptive statistics and ROC curve analysis to determine the IOD cut-off values for predicting MMC presence.
Results
The prevalence of MMC was 21.9% in first molars and 5.53% in second molars. In first molars, the most common MMC configuration was confluent (57.14%), followed by fin (34.29%). The median IOD was significantly greater in teeth with MMC, with cut-off values of ≥3.1mm for first molars and ≥2.9mm for second molars. ROC curve analysis revealed an AUC of 0.766 for first molars and 0.713 for second molars, indicating acceptable discrimination.
Conclusion
MMC is prevalent in the West Bengal population, especially in first molars. The IOD between MB and ML canals is a significant predictor of MMC, enhancing detection and improving endodontic outcomes. The findings underscore the importance of using IOD measurements in identifying MMC during endodontic procedures.
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2. Ballullaya SV, Vemuri S, Kumar PR. Variable permanent mandibular first molar: Review of literature. J Conserv Dent. 1;16:99-110.
3. Paul B, Dube K. Identification and endodontic management of middle mesial canal in mandibular second molar using cone beam computed tomography. Case reports in Dentistry.867976.
4. Keles A, Keskin C. Deviations of mesial root canals of mandibular first molar teeth at the apical third: a micro–computed tomographic study. Journal of Endodontics. 1;44:1030-2.
5. Mahajan S, Meena N, Rangappa A, Mashood AM, Murthy C, Lokapriya M. Evaluation of interorifice distance in permanent mandibular first molar with middle mesial canal in Bengaluru city, Karnataka: A cone-beam computed tomography study. Endodontology. 1;35:100-6.
6. Honap MN, Devadiga D, Hegde MN. To assess the occurrence of middle mesial canal using cone-beam computed tomography and dental operating microscope: An in vitro study. J Conserv Dent. 2020
7. Solete P, Antony DP, Govindaraju L, Kavoor S, Chandragupta MS. Endodontic management of middle mesial canal in mandibular molars: a report of three cases. Cureus.;15.
8. Nosrat A, Deschenes RJ, Tordik PA, Hicks ML, Fouad AF. Middle mesial canals in mandibular molars: incidence and related factors. Journal of endodontics. 1;41:28-32.
9. Baldassari-Cruz LA, Lilly JP, Rivera EM. The influence of dental operating microscope in locating the mesiolingual canal orifice. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1;93:190-4.
10. Aminsobhani M, Bolhari B, Shokouhinejad N, Ghorbanzadeh A, Ghabraei S, Rahmani MB. Mandibular first and second molars with three mesial canals: a case series. Iranian endodontic journal.;5:36.
11. Nagmode PS, Patel AV, Satpute AB, Gupta PL. Endodontic management of mandibular first molars with mid mesial canal: A case series. J Conserv Dent. 1;20:137-40.
12. Natanasabapathy V, Rajesh PS, Ashritha MC, Mishra A, Namasivayam A, Kandaswamy D, Srinivasan MR. Root canal isthmi and interorifice distance in human permanent teeth of an Indian subpopulation using cone-beam computed tomography: A retrospective cross-sectional study. J Conserv Dent. 1;23:563-70.
13. Arun N, Pradeep S. Radiographic analysis of interorifice distance and canal configuration in mesial roots of mandibular first molars. International Journal of Health Sciences.(II):4327-35.
14. Hosmer DW, Lemeshow S. Chapter 5. In: Applied Logistic Regression. 2nd Ed. ed. New York u.a.: Wiley; 2000. p. 160–4
15. Baugh D, Wallace J. Middle mesial canal of the mandibular first molar: a case report and literature review. Journal of endodontics. 1;30:185-6.
16. Penukonda R, Pattar H, Nambiar P, Al-Haddad A. Middle mesial canal in mandibular first molar: a narrative review. The Saudi Dental Journal. 1;35:468-75.
17. Iqbal S, Kochhar R, Kumari M. Prevalence of middle mesial canal in the Indian subpopulation of Greater Noida and the related variations in the canal anatomy of mandibular molars using cone-beam computed tomography. Endodontology. 1;34:50-4.
18. Shakeri FA, Azizi HA, Razian F, Haghanifar S, Hoshyari N. Prevalence of mid-mesial canal and isthmuses in mandibular first and second molars in an Iranian population.
19. Azim AA, Deutsch AS, Solomon CS. Prevalence of middle mesial canals in mandibular molars after guided troughing under high magnification: an in vivo investigation. Journal of endodontics. 1;41:164-8.
20. Weinberg EM, Pereda AE, Khurana S, Lotlikar PP, Falcon C, Hirschberg C. Incidence of middle mesial canals based on distance between mesial canal orifices in mandibular molars: a clinical and cone-beam computed tomographic analysis. Journal of Endodontics. 1;46:40-3.
21. Keleş A, Keskin C. Detectability of middle mesial root canal orifices by troughing technique in mandibular molars: a micro–computed tomographic study. Journal of Endodontics. 1;43:1329-31.
22. Yang Y, Wu B, Zeng J, Chen M. Classification and morphology of middle mesial canals of mandibular first molars in a southern Chinese subpopulation: a cone-beam computed tomographic study. BMC Oral Health.;20:1-0.
23. Karapinar-Kazandag M, Basrani BR, Friedman S. The operating microscope enhances detection and negotiation of accessory mesial canals in mandibular molars. Journal of Endodontics. 1;36:1289-94.
24. Sherwani OA, Kumar A, Tewari RK, Mishra SK, Andrabi SM, Alam S. Frequency of middle mesial canals in mandibular first molars in North Indian population-An in vivo study. Saudi Endodontic Journal. 1;6:66-70.
25. Kuzekanani M, Walsh LJ, Amiri M. Prevalence and distribution of the middle mesial canal in mandibular first molar teeth of the Kerman population: a CBCT study. International Journal of Dentistry.:8851984.
Published
2025-02-28
How to Cite
Gupta, P., Kallol Kumar Saha, Ujjwal Das, Parthasarathi Mondal, Kurchi Mandal, & Kuntal Chowdhury. (2025). Prevalence & Location of Mid Mesial Canal Based on Interorifice Distance Between MB-Ml Canals in Permanent Mandibular 1st, 2nd Molars In West Bengal Population – “A Cone Beam Computed Tomography Study”. UNIVERSITY JOURNAL OF DENTAL SCIENCES, 11(1). https://doi.org/10.21276/ujds.2025.11.1.3
Section
Original Research Paper
