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Prevalence and morphological characteristics of disto-lingual roots in mandibular first molars: a cone beam CT study with diagnostic and therapeutic implications

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Abstract

Objectives

High prevalence of disto-lingual roots (DLR) at the mandibular molar in Chinese can complicate the management of periodontitis. This study assessed the prevalence and morphological features of mandibular first molar DLR and furcation entrances in a Hong Kong population by analysis of cone beam computed tomography (CBCT).

Materials and methods

CBCT including the mandibular 1st molar region were identified from the Prince Philip Dental Hospital archive and analyzed by a single investigator. Morphologic features and location of DLR were studied and presented as 95% confidence intervals.

Results

A total of 398 CBCTs with 716 mandibular first molars were analyzed. The prevalence of DLRs in mandibular first molars on subject based was 20.1% (95% C.I. 16.2–24%). DLR was located 44.5° ± 8.9° (95% C.I. 42.8–46.1°) to the mid-lingual of the mandibular first molar, with a bucco-lingual width 3.3 mm ± 0.5 mm (95% C.I. 3.2–3.4 mm). The mesial furcation entrance was located 4.0 mm ± 0.9 mm (95% C.I. 3.8–4.2 mm) apical to the cemento-enamel junction (CEJ) while the distal was 5.2 mm ± 1.3 mm (95% C.I. 5.0–5.4 mm) from the CEJ. The surface area of the DLR was 106.9 mm2 ± 41.2 mm2 (95% C.I. 98.9–114.8 mm2).

Conclusions

Chinese population has a high prevalence of DLRs. The present information is critical for understanding the morphological features of DLR and guide diagnosis and treatment of stage III periodontitis as well as for secondary prevention and supportive care of stage II periodontitis.

Clinical relevance

Little is known about the location and morphology of disto-lingual roots of mandibular 1st molars, yet they are frequently present in patients with Chinese ethnic background, thus complicating diagnosis and treatment. The present study utilized CBCT to analyze the prevalence and morphological features of the mandibular first molar DLR and furcation entrance. It is the first study reporting on the position of the DLR, degree of separation of the furcation, and the surface area of the DLR.

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Funding

The work was supported by the Periodontology and Implant Dentistry, Faculty of Dentistry, University of Hong Kong and Health and Medical Research Fund (Fund No.: 07182796)

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Authors and Affiliations

  1. Division of Periodontology and Implant Dentistry, Faculty of Dentistry, 3B Prince Philip Dental Hospital, University of Hong Kong, 34 Hospital Road, Hong Kong, SAR, China

    Dominic King Lun Ho, Janet H. L. Wong, Georgios Pelekos, Ke Deng & Maurizio S. Tonetti

  2. European Research Group on Periodontology, Genoa, Italy

    Maurizio S. Tonetti

Authors
  1. Dominic King Lun Ho
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  2. Janet H. L. Wong
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  3. Georgios Pelekos
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  4. Ke Deng
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  5. Maurizio S. Tonetti
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Correspondence to Maurizio S. Tonetti.

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The authors declare that they have no conflict of interest.

Ethical approval

This article contains a retrospective study conducted on already available data. Ethics approval (UW-18-262) was granted by the Institutional Review Board of the University of Hong Kong/Hospital Authority of Hong Kong West Cluster (HKU/HA HKW IRB) to ensure that research complies with the Declaration of Helsinki and acts in accordance to IDH GCP guidelines, local regulations, and Hospital Authority and the University policies. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ho, D.K.L., Wong, J.H.L., Pelekos, G. et al. Prevalence and morphological characteristics of disto-lingual roots in mandibular first molars: a cone beam CT study with diagnostic and therapeutic implications. Clin Oral Invest 25, 4023–4030 (2021). https://doi.org/10.1007/s00784-020-03733-3

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  • DOI: https://doi.org/10.1007/s00784-020-03733-3

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