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

Pertek Hatipoğlu F. Mağat G. Hatipoğlu Ö. Taha N. Alfirjani S. Abidin I.Z. Lehmann A.P. Alkhawas M.-B.A.M. Buchanan G.D. Kopbayeva M. Surendar S. Javed M.Q. Madfa A.A. Donnermeyer D. Krmek S.J. Bhatti U.A. Palma P.J. Brochado Martins J.F.
May 2023 Elsevier Inc.

Journal of Endodontics
2023 #49 Issue 5 549 - 558 pp.

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). MMC prevalence ranged from 1% to 23%, and the overall prevalence was 7% (95% confidence interval [CI]: 5%–9%). No significant differences were found between the left and right M1M (odds ratio = 1.09, 95% CI: 0.93, 1.27; 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.

Cone-beam computed tomography , endodontics , prevalence studies , root canal

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Department of Endodontics, Nigde Omer Halisdemir University, Niğde, Turkey
Department of Oral Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
Department of Restorative Dentistry, Nigde Omer Halisdemir University, Niğde, Turkey
Department of Conservative Dentistry, Jordan University of science and Technology, Irbid, Jordan
Department of Conservative Dentistry and Endodontics, University of Benghazi, Benghazi, Libya
International Islamic University Malaysia (IIUM), Kuala Lumpur, Malaysia
Poznań University of Medical Sciences Dept. of Conservative Dentistry and Endodontics Poznań, Poznań, Poland
Professor and Head of Endodontic Department, Al-Azhar University, Cairo, Egypt
Department of Odontology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
Kazakh National Medical University Asfendiyarov, Almaty, Kazakhstan
Department of Conservative Dentistry and Endodontics, Saveetha Dental College & Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Tamil Nadu, Chennai, India
Department of Conservative Dental Sciences, College of Dentistry, Qassim University, Buraydah, Qassim, Saudi Arabia
Department of Restorative Dental Science, Collage of Dentistry, University of Hail, Hail, Saudi Arabia
Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, Yemen
Department of Periodontology and Operative Dentistry, Westphalian Wilhelms-University, Münster, Germany
Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
Department of Operative Dentistry and Endodontics, Riphah International University, Pakistan
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
Department of Endodontology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, Netherlands

Department of Endodontics
Department of Oral Radiology
Department of Restorative Dentistry
Department of Conservative Dentistry
Department of Conservative Dentistry and Endodontics
International Islamic University Malaysia (IIUM)
Poznań University of Medical Sciences Dept. of Conservative Dentistry and Endodontics Poznań
Professor and Head of Endodontic Department
Department of Odontology
Kazakh National Medical University Asfendiyarov
Department of Conservative Dentistry and Endodontics
Department of Conservative Dental Sciences
Department of Restorative Dental Science
Department of Conservative Dentistry
Department of Periodontology and Operative Dentistry
Department of Endodontics and Restorative Dentistry
Department of Operative Dentistry and Endodontics
Center for Innovation and Research in Oral Sciences (CIROS)
Institute of Endodontics
Department of Endodontology

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