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

Fatma Pertek Hatipoğlu, Güldane Mağat, Ömer Hatipoğlu*, Nessrin Taha, Suha Alfirjani, Imran Zainal Abidin, Anna Paulina Lehmann, Moataz Bellah Ahmed Mohamed Alkhawas, Glynn Dale Buchanan, Maira Kopbayeva, Sugumaran Surendar, Muhammad Qasim Javed, Ahmed A. Madfa, David Donnermeyer, Silvana Jukić Krmek, Usman Anwer Bhatti, Paulo J. Palma, João Filipe Brochado Martins

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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). 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.

Original languageEnglish
Pages (from-to)549-558
Number of pages10
JournalJournal of endodontics
Volume49
Issue number5
Early online date28 Feb 2023
DOIs
Publication statusPublished - May 2023

Bibliographical note

Funding Information:
The authors deny any conflicts of interest related to this study.

Publisher Copyright:
© 2023 American Association of Endodontists

Funding

The authors deny any conflicts of interest related to this study.

Keywords

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

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