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Missed canals in endodontically treated maxillary molars of a Brazilian subpopulation: prevalence and association with periapical lesion using cone-beam computed tomography

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Abstract

Objectives

To evaluate the prevalence of missed canals in endodontically treated maxillary molars through cone-beam computed tomography (CBCT) images and to verify their association with the presence of periapical lesions.

Material and methods

Three oral radiologists evaluated 633 maxillary molars in CBCT exams regarding number of roots, number of root canals, number of missed canals, anatomic identification of missed canals, presence of periapical lesions, and root location of the periapical lesions. Data were statistically analyzed at a 5% significance level.

Results

Descriptive statistical analysis showed that among 395 first molars, 218 had at least one missed canal, and 186 (46.5%) had a missed canal and periapical lesion simultaneously. Of these, 72.4% (134) of the missed canals were only mesiobuccal 2 (MB2). Among 238 s molars evaluated, 121 presented at least one missed canal, and 104 (43.6%) had a missed canal and periapical lesion simultaneously. Of these, 81.7% (85) of the missed canals were only MB2. The chi-squared test showed an association between the presence of missed canals and periapical lesions for 1st and 2nd maxillary molars. Teeth that presented a missed canal showed an odds ratio (OR) of 2.57 (p < 0.0001) of being associated with a periapical lesion. Missed canal occurrence was positively related to the number of root canals (z = 13.06, p < 0.0001), meaning when the number of root canals is higher, there is a higher probability of missed canal occurrence. According to the model calculated prediction, for a one-unit increase in the number of canals, the probability of missed canals increases by 4.22%.

Conclusions

It was concluded that MB2 was the most frequently missed canal, associated with the presence of periapical lesions in endodontically treated maxillary molars.

Clinical relevance

Professionals’ negligence of anatomical root variations has been contributed to the high prevalence of missed canals, leading to failures in endodontic treatment. Their association with periapical lesion occurrence emphasizes the importance of correct detection and instrumentation of these canals.

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Funding

The authors are grateful to Federal University of Juiz de Fora, for financial support.

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Authors and Affiliations

  1. Department of Dentistry, Federal University of Juiz de Fora, Campus GV (UFJF-GV), Av. Dr. Raimundo Rezende, 330, Centro, Sala 301, Governador Valadares, Minas Gerais, 35010-177, Brazil

    Weslley Duarte do Carmo, Francielle Silvestre Verner, Larisse Martins Aguiar, Mariane Floriano Lopes Santos Lacerda & Rafael Binato Junqueira

  2. School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil

    Maria Augusta Visconti & Matheus Diniz Ferreira

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  1. Weslley Duarte do Carmo
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Correspondence to Rafael Binato Junqueira.

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Conflict of interest

Weslley Duarte do Carmo declares that he has no conflict of interest. Francielle Silvestre Verner declares that she has no conflict of interest. Larisse Martins Aguiar declares that she has no conflict of interest. Maria Augusta Visconti declares that she has no conflict of interest. Matheus Diniz Ferreira declares that he has no conflict of interest. Mariane Floriano Lopes Santos Lacerda declares that she has no conflict of interest. Rafael Binato Junqueira declares that he has no conflict of interest.

Ethical approval

This study was approved by the Research Ethics Committee of Human Research of Federal University of Juiz de Fora under protocol #2.650.830/2018. All procedures performed that involved 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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do Carmo, W.D., Verner, F.S., Aguiar, L.M. et al. Missed canals in endodontically treated maxillary molars of a Brazilian subpopulation: prevalence and association with periapical lesion using cone-beam computed tomography. Clin Oral Invest 25, 2317–2323 (2021). https://doi.org/10.1007/s00784-020-03554-4

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