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K. S. Al-Fouzan
Dental Department, King Fahad National Guard Hospital, Riyadh, Kingdom of Saudi Arabia
Abstract
Al-Fouzan KS. C-shaped root canals in mandibular second
molars in a Saudi Arabian population. International Endodontic Journal, 35, 499^504, 2002
Aim The aim of this study was to determine the frequency of C-shaped canals in mandibular second
molars in a population in Saudi Arabia and to establish a classication for the most common congurations.
Methodology One hundred and fty-one mandibular second molars scheduled for root-canal treatment
were examined over a 1-year period. The C-shaped
canals were detected by radiographic and clinical
examination. Teeth with C-shaped canal systems were
Introduction
A thorough knowledge of the anatomy of teeth involved
in root-canal treatment is essential for successful debridement and obturation of the root-canal system. Recognition of unusual canal congurations and variations
are paramount, because it has been established that
the root with a single tapering canal and apical foramen
is the exception rather than the rule (Abou-Rass et al.
1980).
Of particular interest is the canal conguration of
the mandibular second molar as a great deal of variation can occur, C-shaped canals are common (Cooke &
Cox 1979) with the presence of a thin n connecting
the root canals being the main anatomical feature
(Barril et al. 1989). Once recognized, the C-shaped
canal provides a challenge with respect to debridement and obturation, especially because it is unclear
whether the C-shaped orice found on the oor of the
499
500
Melton et al. 1991). Clearly, the recognition of these congurations facilitates cleaning, shaping, and obturation
(Rice & Gilbert 1987). Preoperative radiographs demonstrate close fused roots or images of two distinct roots.
This occurs when the n is thin and thus, not visible
on the X-ray and makes clinical recognition of the
C-shaped canal unlikely until access to the pulp chamber has been achieved (Barril et al. 1989). Radiographs
taken whilst negotiating the root-canal system may suggest such anatomyas theycan reveal two characteristics:
instruments tending to converge at the apex (Rice & Gilbert 1987) or instruments appearing both clinically
and radiographically to be centered and appearing to
be exiting the furcation (Fig. 1).This can cause confusion
and initiate a search for a perforation (Barril et al. 1989,
Melton et al. 1991).
The C-shaped canals were rst documented by Cooke
& Cox (1979) in three case reports. Similar reports have
501
Category II:semicolon (;) shaped orice in which dentine separated a main C-shaped canal from one mesial
distinct canal (Fig. 3).
Category III: subdivision I, C-shaped orice in the coronal third that divided into two or more discrete and
separate canals that joined apically (Fig. 4); subdivision II, C-shaped orice in the coronal third that
divided into two or more discrete and separate canals
in the mid-root to the apex (Fig. 5); and subdivision
III, C-shaped orice that divided into two or more discrete and separate canals in the coronal third to the
apex (Fig. 6).
Results
Of the 151 molars,16 (10.6%) exhibited C-shaped canals.
Five molars presented a continuous C-shaped canal
(category I), and three had a semicolon shape (category
II) with a mesial canal located on the buccal or lingual
502
Discussion
Previously reported dierences in the root-canal anatomy of mandibular second molars may be owing to the
population from which the teeth were chosen. If a Caucasian population were studied, then predominantly tworooted mandibular second molars could be expected
(Ainamo & Loe 1968, Tamse & Kae 1981, Vertucci 1984,
Weine et al. 1988), whereas if an Asian or Mongoloid
population were examined then a higher number of
teeth would be single-rooted (Kotoku 1985, Walker
Figure 7 C-shaped chamber oor showing a complete Cshaped root-canal orice in the form of a deep trough
connecting the distal, mesiobuccal and mesiolingual canal
orices.
503
Conclusions
Mandibular second molars with C-shaped canals vary
in canal conguration. The early recognition of these
congurations facilitates cleaning, shaping, and obturation of the root-canal system. The possibility of CShaped canals has to be considered during the clinical
and radiographic examination of the patient.
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