Morphological Characteristics and Classification of Mandibular First Molars Having 2 Distal Roots or Canals: 3-Dimensional Biometric Analysis Using Cone-beam Computed Tomography in a Korean Population

Introduction: The aim of this study was to determine the morphologic characteristics of mandibular first molars having 2 canals in distal roots. Interorifice distance, buccal bone thickness, and root curvature were evaluated using cone-beam computed tomography images in a Korean population. Methods: In total, 1958 mandibular first molars were evaluated in axial, coronal, sagittal, and paraxial planes. Distal roots having 2 canals were classified according to their root and canal shapes (2 roots, 2 canals [2R2C]; 1 root, 2 canals with 2 apical foramina [1R2C(2-2)]; and 1 root, 2 canals with 1 apical foramen [1R2C(2-1)]). The distances between orifices and the distance from the apex to the buccal bone plate were measured for each root canal shape (2R2C, 1R2C[22], and 1R2C[2-1]). The curvature of distolingual (DL) roots was classified according to severity using 3 dimensional reconstructed images, and the direction of curvature was determined. The relationships of these characteristics to sex and side were evaluated. Results: The prevalences of 2R2C, 1R2C(2-2), and 1R2C(2-1) were 25.89%, 10.32%, and 14.15%, respectively. The distances between distobuccal (DB) and DL orifices were 3.77 +/- 0.74 mm for 2R2C, 3.02 +/- 0.65 mm for 1R2C(2-2), and 2.44 +/- 0.64 mm for 1R2C(2-1). The distances from the buccal plate to the DB canal were 3.84 +/- 1.35 mm for 2R2C, 5.33 +/- 1.41 mm for 1R2C(2-2), and 5.96 +/- 1.63 mm for 1R2C(2-1). The distance from the buccal plate to the DL canal was 9.85 +/- 1.46 mm for 2R2C, and 8.28 +/- 1.50 mm for 1R2C(2-2). All distances differed significantly according to root canal configurations, and all were greater in men than women (P < .05), except for the DB-DL orifice distance in 1R2C(22) and the DB to buccal cortical plate distance in all root configurations (P > .05). No significant difference between the left and right sides was found (P > .05). The prevalence of most severely curved DL roots (type III) was 62.92%, and the direction was commonly toward the buccal side (69.03%). Conclusions: The prevalence of mandibular first molars having 2 canals in distal roots was more than 50% in a Korean population. Interorifice distances between DB and DL canals and distances from the apex to the buccal cortical plate differed according to root and canal numbers and shapes.