Assessment of The Prevalence of Middle Mesial Canal in Mandibular First Molar; A Multinational Cross-Sectional Study With Meta-Analysis
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 CBCT images was evaluated in 15 countries, along with the effect of some demographic factors on its prevalence.
METHOD
De-identified Cone Beam Computed Tomography (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 three-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 12608 M1Ms, were evaluated. A significant difference was found between countries (p 0.05) or between genders (OR= 1.07, 95% CI:0.91,1.27; p> 0.05). As for the other age groups, no significant differences were found (p>0.05) CONCLUSION: 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 MM1s, due to the prevalence of MMC being significantly bilateral.
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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