Second Mandibular Molar Roots in Relation to Mandibular Canal in Cone Beam Computed Tomography

Abstract

Keywords: Mandibular second molar, mandibular nerve, localization of the roots, iatrogenic injuries, complications. 

Objective: To evaluate the relationship of the roots of the second mandibular molar to the mandibular canal in cone beam computed tomography (CBCT).

Methods: Cross-sectional study. The study included 200 patients, both genders (aged 15 to 56 years, mean age 35) who underwent CBCT examinations during the last 10 years by i-CAT Next Generation (Kavo, voxel size 0.300mm) at the Riga Stradins University Department of Radiology. Altogether 375 teeth were analyzed. Kavo eXamVision program was used for CBCT examination analysis. Data processing with MS Excel and IBM SPSS. The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Riga Stradins University (protocol Nr. 2-4/459/2023, date of approval 9.06.2023).

Results: The most frequent distance from the mandibular second molar to the mandibular canal was 1.01– 3.00 mm, direct contact with the canal was observed in up to 21.2% of cases. Penetration of the root apex into the mandibular canal was observed in up to 1.2%. The most frequent position of the canal was apical (84.2–97.5 %). The obtained results are clinically significant. 

Conclusions: Direct contact between the apex of the root of the second mandibular molar and the mandibular canal is a fairly common phenomenon, in most cases the distance between these structures is less than 3.00 mm. When performing root canal treatment, the dentist must be extremely careful to avoid iatrogenic injuries to the alveolar nerve, which can significantly reduce patient’s quality of life.