• Imaging Science in Dentistry
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• v.45 no.4
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• pp.221-226
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• 2015

Purpose: This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. Materials and Methods: Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. Results: Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. Conclusion: The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar.

• The Journal of the Korean dental association
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• v.56 no.12
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• pp.695-706
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• 2018

Objectives: The purpose of this study was to investigate the ratio of 4 root canals and the incidence of Radix Entomolaris in mandibular first molars and find out anatomical difference according to number of roots by analysis of cone-beam CT images in a Korean population. Materials and Methods: Total 142 images containing mandibular first molars were selected from CBCT images taken from 2013 to 2017 at Gangneung-Wonju National University Dental Hospital. After reconstructing the image with reference to the Cemento-enamel junction, the root canals were detected at the bottom of the pulpal floor and the number of roots and root canals were analyzed. Various lengths and MLO-DLO-DBO angle were measured between each canal orifices and the external contour line of the tooth, and the distolingual canal wall thickness was measured. Student t-test was used for statistical significance. Results: Among the total 142 teeth, 4 canals were 42.2% and Radix Entomolaris was 25.3%. As the results of measuring various lengths and the angle, the distolingual canal orifice in Group 2(with Radix Entomolaris) tends to deviate to the lingual side than the mesiolingual canal orifice and to the mesial side than the distobuccal canal orifice. Besides, thickness of the distolingual canal wall in Group 2(with Radix Entomolaris) was significantly thinner than that of Group 1 at every level except pulpal floor level. Conclusion: It is necessary to consider the difference according to the presence of Radix Entomolaris in endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.43 no.3
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• pp.33.1-33.8
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• 2018

Objectives: This study aimed to investigate the prevalence of a separate distolingual root and to measure the thickness of the buccal cortical bone in mandibular first molars in Koreans using cone-beam computed tomography (CBCT) images. Materials and Methods: High-quality CBCT data from 432 patients were analyzed in this study. The prevalence of a separate distolingual root of the mandibular first molar was investigated. The distance from the distobuccal and distolingual root apices to the outer surface of the buccal cortical bone was measured. We also evaluated the thickness of the buccal cortical bone. Results: The prevalence of a separate distolingual root (2 separate distal roots with 1 canal in each root; 2R2C) was 23.26%. In mandibular first molars with 2R2C, the distance from the distobuccal root apex to the outer surface of the buccal cortical bone was 5.51 mm. Furthermore, the distance from the distolingual root apex to the outer surface of the buccal cortical bone was 12.09 mm. In mandibular first molars with 2R2C morphology, the thickness of the buccal cortical bone at the distobuccal root apex of the mandibular first molar was 3.30 mm. The buccal cortical bone at the distobuccal root apex was significantly thicker in the right side (3.38 mm) than the left side (3.09 mm) (p < 0.05). Conclusions: A separate distolingual root is not rare in mandibular first molars in the Korean population. Anatomic and morphologic knowledge of the mandibular first molar can be useful in treatment planning, including surgical endodontic treatment.

• Imaging Science in Dentistry
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• v.39 no.2
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• pp.89-92
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• 2009

Purpose: To assess the angle between mandibular canal and occlusal plane at each posterior tooth region and location of mental foramen on the panoramic radiographs. Materials and Methods: This study analysed 46 half-mandibles of panoramic radiographs. Inferior border of mandibular canal was traced. Occlusal plane was drawn from lingual cusp tip of the first premolar to distolingual cusp tip of the second molar. Perpendicular line from occlusal plane was drawn at each tooth region and then tangential lines were drawn from the crossing points at canal. the angle between occlusal plane and tangential line was measured. The location of mental foramen was also studied. According to the location of mental foramen, radiographs were divided into M (mesial) group and D (distal) group on the basis of the second premolar. and then inter-group analysis about mandibular canal angle was done. Results: The angles of mandibular canals were -17.7$^{\circ}$, -9.5$^{\circ}$, 8.2$^{\circ}$, 22.3$^{\circ}$, and 39.2$^{\circ}$at first premolar, second premolar, first molar, second molar, and third molar, respectively. The commonest position of the mental foramen was distal to the second premolar. Inter-group comparison showed statistically significant difference at the second premolar and the first molar(p<0.001). Conclusion: The knowledge of mandibular canal angle and location of mental foramen can help understanding the course of mandibular canal. (Korean J Oral Maxillofac Radiol 2009; 39: 89-92)

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.4
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• pp.400-408
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• 2019

The purpose of this study is to identify the most common canal type in primary molars and the correlation between their roots and canals. A comprehensive understanding of root canal morphology will lead to more successful root canal treatment. Computed Tomography (CT) images from 114 children (81 boys, 33 girls) aged 3 - 7 years were obtained. The locations and numbers of roots and canals were evaluated, and the relationship between root and canal parameters was determined. The most commonly observed canal morphology in primary maxillary molars were mesio-buccal, disto-buccal and palatal canal. Primary mandibular molars most frequently contain mesio-buccal, mesio-lingual, disto-buccal and distolingual canal. All the roots of the primary maxillary molars except for the mesio-buccal root, each had 1 canal while there were 2 canals observed in each root of primary mandibular molars. Without exception, all mesial roots in primary mandibular 2nd molars had 2 canals. In case when either the palatal root in a primary maxillary molar or the distal root in a primary mandibular molar was separated into 2 roots, each root seemed to have its own canal. Even though the disto-buccal and palatal roots were fused into 1 root in primary maxillary molars, this fused root had tendency to have 2 separate canals. Primary mandibular molars showed similar canal morphologies between left and right molars in the same patient, while the primary maxillary molars did not.

• Restorative Dentistry and Endodontics
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• v.39 no.2
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• pp.132-136
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• 2014

The presence of radix entomolaris (RE) in a mandibular first molar is a common occurrence in certain ethnic groups, but the presence of RE in a mandibular second molar is a rare occurrence. In the present case, RE was identified from preoperative radiographs and confirmed using cone-beam computed tomography (CBCT). The access cavity was modified to locate the RE. Cleaning and shaping were performed with nickel-titanium rotary instruments. Obturation was completed with gutta-percha cones using AH Plus (Dentsply Detrey GmbH) as sealer. From the CBCT axial images, the RE was determined to have a Type III curvature by the De Moor classification, Type B separate RE by the Carlsen and Alexandersen classification, and radiographically, a Type i image by the Wang classification. The presence of RE in the mandibular second molar makes it essential to anticipate and treat the distolingual root canal. This case report highlights the usefulness of CBCT for assessing RE in the mandibular second molar, which can help the clinician in making a confirmatory diagnosis and assessing the morphology of the root canal.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.167-174
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• 2008

Mandibular first molar and primary molars usually have two roots, on the mesial and distal sides. Occasionally, these molars have an extra root located in the distolingual aspect. Prevalence of the 3-rooted first permanent molar shows ethnic variation, ranging from about 3% in Caucasian to about 20% in Mongoloid group, which includes Chinese, Japanese, Eskimo, American and Canadian Indians. The frequency of the mandibular molar with three roots decreases in the order of the first permanent molar, the second primary molar, and the first primary molar. If the mandibular first or second primary molar has an additional distolingual root, the adjacent molars, including the first permanent molar, posterior to it also may have it. Coronal morphologic change can occur in the mandibular first primary molars with three roots: the crown had more triangular-shape compared to the one with two roots, possibly affected by the presence of additional distolingual root. Clinically, exact diagnosis and treatment should be taken with those teeth for pulp canal treatment, extraction, and SS Cr.

• Restorative Dentistry and Endodontics
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• v.34 no.2
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• pp.137-144
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• 2009

The aim of this study was to investigate the shapes and diameters of the physiological foramen and anatomy of the root canal at 3mm from apex in mandibular first molars. Sixty mandibular first molars were randomly selected. The apical anatomy of 60 mandibular first molars was investigated by means of a stereo microscope (60x magnification). The results were as follows; 1. There was a high percentage of two physiological foramina in mesial (61.67%) and one foramen in distal(71.66%) roots of mandibular first molars. 2. There was a high frequency of accessory foramina in mesial roots with one foramen (26.07%). 3. The diameters of physiological foramen was as follows: - 0.329mm in single mesial foramen - 0.266mm in mesiobuccal foramen and 0.246mm in mesiolingual foramen - 0.375mm in single distal foramen - 0.291mm in distobuccal foramen and 0.237mm in distolingual foramen 4. The most common physiological foramen shape was oval (69.93%). 5. The incidence of isthmus in mesial root at 3mm from apex was 55%. The 3mm-sections contained a complete isthmus 31.66% and a partial isthmus 23.34%. 6. 3mm from the apex, the most common canal shape was oval (50.64%). Knowledge of the apical anatomy of mandibular first molar would be necessary for success of surgical and nonsurgical endodontic treatment.

• Restorative Dentistry and Endodontics
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• v.45 no.1
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• pp.7.1-7.9
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• 2020

Objectives: This study was performed to assess the anatomy of mandibular first molars. Materials and Methods: In this in vivo study, cone-beam computed tomography (CBCT) volumes of 312 bilateral intact first mandibular molars from 156 patients (79 men and 77 women; average age, 35.6 ± 11.2 years) were investigated in terms of the direction of each canal's curvature in the buccolingual and mesiodistal dimensions (direction of the position of the apex in relation to the longitudinal axis of the root), the presence of an isthmus (a narrow, ribbon-shaped communication between 2 root canals) in 3 segments (0-2, 2-4, and 4-6 mm) from the apex), and the presence and number of accessory canals (smaller canals besides the main root canals, connecting the pulp to the periodontium). Data were analyzed statistically (α = 0.05). Results: Mesiolingual canals were mostly buccally and distally inclined, while mesiobuccal and distolingual canals were mostly distally curved. Isthmuses were more common in younger patients (χ² test, p < 0.05). The average numbers of accessory canals in the apical, middle, and coronal segments were 9.9 ± 4.2, 6.9 ± 2.9, and 9.3 ± 3.0 canals per segment, respectively (analysis of variance, p < 0.001). Age and sex were not associated with the number of accessory canals (p > 0.05). Conclusions: The complex anatomy of these teeth deserves attention during non-surgical or surgical endodontic treatment. Around the apex, isthmuses might be more prevalent in younger and female individuals.