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Incidence of Middle Mesial Canal in the Mandibular First Molar in the Tunisian Population: A Cone Beam Computed Tomography Analysis


Latifa Hammouda1*, Hamed Harbi1, Sonia Zouiten1, Faten Ben Amor1 and Nabiha Douki

Background: Failures of endodontic treatment are mainly due to an untreated canal and ignorance of the practitioner about the anatomy of the canal system. The middle mesial canal is one such type of canal in mandibular molars which is often missed. The purposes of this retrospective study were:

1. To assess the frequency of the Middle Mesial Canals (MMCs) in the mandibular 1st molars and its anatomy configuration type in the Tunisian population using CBCT images.

2. To correlate the incidence of MMCs with variables of sex, age and presence of a second distal canal.

Methods: 123 CBCT images were obtained, between December 2013 to October 2019, from the database of the out-patient department, faculty of dentistry, Monastir University. Mesial canals number and mesial canals system configuration CBCT were evaluated by Gallileos Viewer. 196 mature permanent first mandibular molars were included in this study. CBCT images were examined to detect the number of canals and canal configuration. The mesial root canal morphology was categorized and compared according to Vertucci and the Pomeranz classification for the MMCs configuration.

Results: The incidence of the presence of MMCs in the first mandibular molars among the Tunisian population was 13.77% (27/196). The differences in the distribution of MMCs based on sex and presence of a second distal canal were not significant (p>0,05). While MMC configuration types showed 62,96% (17/27) confluent anatomy merging with either the mesio buccal or mesio lingual canals; 29,62% (8/27) fin anatomy and only 7.4% (2/27) showed independent MMCs with separate orifices and apical foramen. The most common mesial root canal morphological type was type II (3-2) (63, 63%). This study revealed that MMCs are located equidistant to both the mesio buccal and the mesio lingual canals in 16 cases (59,25%) and are located closer to the mesio buccal canals in 6 cases (22,22%). The frequency of the presence of third mesial canal in the mandibular molars decreases with age.

Conclusion: The MM canals prevalence in mandibular 1st molars in the Tunisian population was 13.77%. CBCT can be a helpful method in the identification and negotiation of this canal.

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