Assessment of the relationship of the distance between mandibular first and second molars with the inferior alveolar canal and cortical bone plate in an Egyptian subpopulation: a CBCT study

Sharaan, Marwa El-Sayed; Abdulla, Asmaa Yousry; Ragab, Mai Hamdy

doi:10.1590/1807-3107bor-2022.vol36.0033

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Original Research, Endodontic Therapy • Braz. oral. res. 36 • 2022 • https://doi.org/10.1590/1807-3107bor-2022.vol36.0033 copy

Assessment of the relationship of the distance between mandibular first and second molars with the inferior alveolar canal and cortical bone plate in an Egyptian subpopulation: a CBCT study

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

The aim of the current cone beam computed tomography (CBCT) study was to evaluate the proximity of mandibular first and second molar roots to the inferior alveolar canal (IAC) and mandibular cortex in an Egyptian subpopulation. Scans of 120 patients (480 molars, 960 roots) were obtained from the College of Dentistry database at the Suez Canal University, Egypt. Buccal and lingual bone plates and root thickness were measured at the specified resected root end 3 mm from the radiographic apex, and so was the proximity of the root apices to the IAC. Measurements of the right and left mandibular first and second molars were recorded for each root. Three examiners performed the measurements separately. ANOVA was used to compare the different roots. Bonferroni’s post-hoc test was used for pair-wise comparisons when ANOVA was significant. The significance level was set at p ≤ 0.05. The findings displayed a closer proximity of the mandibular second molar apices to the IAC, as compared to the mandibular first molars. The mesial roots were at a shorter distance than the distal ones. Moreover, the mandibular second molars revealed the thickest total bone width including the root. So, it is beneficial for endodontists to be aware of the relation of the mandibular first and second molars to the surrounding cortical bone plates and the IAC before starting either nonsurgical or surgical endodontic treatment.

Keywords:
Cone-Beam Computed Tomography; Mandibular Canal

Measurement point / Tooth and root		Mean	SD	95%CI		p-value	Effect size (Partial Eta Squared)
Measurement point / Tooth and root		Mean	SD	Lower bound	Upper bound	p-value	Effect size (Partial Eta Squared)
M1
	First molar (right mesial)	1.88^B	0.58	1.77	1.99	0.031 ^* * Significant at p ≤ 0.05, Different superscripts in each column within each measurement point indicate a statistically significant difference between roots. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.032
	First molar (right distal)	1.78^B	0.54	1.68	1.88
	First molar (left mesial)	1.76^B	0.56	1.65	1.86
	First molar (left distal)	1.77^B	0.48	1.68	1.85
	Second molar (right mesial)	2.07^A	0.71	1.94	2.2
	Second molar (right distal)	2.11^A	0.66	1.99	2.28
	Second molar (left mesial)	1.69^B	0.74	1.55	1.82
	Second molar (left distal)	1.74^B	0.67	1.61	1.86
M2
	First molar (right mesial)	1.72 ^B	0.5	1.62	1.81	0.004 ^* * Significant at p ≤ 0.05, Different superscripts in each column within each measurement point indicate a statistically significant difference between roots. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.044
	First molar (right distal)	1.76 ^B	0.49	1.67	1.85
	First molar (left mesial)	1.92 ^A	0.62	1.81	2.03
	First molar (left distal)	1.76 ^B	0.54	1.66	1.85
	Second molar (right mesial)	1.63 ^B	0.69	1.51	1.76
	Second molar (right distal)	1.67 ^B	0.66	1.55	1.79
	Second molar (left mesial)	2.05 ^A	0.76	1.91	2.18
	Second molar (left distal)	2.09 ^A	0.71	1.96	2.22
M3
	First molar (right mesial)	3.68 ^B	2.21	3.28	4.09	< 0.001 ^* * Significant at p ≤ 0.05, Different superscripts in each column within each measurement point indicate a statistically significant difference between roots. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.368
	First molar (right distal)	3.87 ^A	2.2	3.47	4.27
	First molar (left mesial)	3.8 ^A	2.06	3.43	4.17
	First molar (left distal)	3.95 ^A	1.93	3.6	4.3
	Second molar (right mesial)	2.11 ^E	2.09	1.73	2.49
	Second molar (right distal)	2.56 ^D	2.06	2.18	2.93
	Second molar (left mesial)	2.43 ^D	2.01	2.07	2.8
	Second molar (left distal)	2.97 ^C	2.05	2.6	3.35
M4
	First molar (right mesial)	12.71 ^B	1.72	12.4	13.02	< 0.001 ^* * Significant at p ≤ 0.05, Different superscripts in each column within each measurement point indicate a statistically significant difference between roots. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.305
	First molar (right distal)	12.17 ^C	1.64	11.87	12.47
	First molar (left mesial)	12.7 ^B	1.66	12.4	13
	First molar (left distal)	12.17 ^C	1.6	11.88	12.46
	Second molar (right mesial)	13.33 ^A	1.99	12.97	13.69
	Second molar (right distal)	13.49 ^A	1.94	13.14	13.84
	Second molar (left mesial)	13.55 ^A	1.87	13.21	13.89
	Second molar (left distal)	13.57 ^A	1.87	13.23	13.91

Measurement point / Tooth and root		Males		Females		p-value	Effect size (Partial Eta Squared)
Measurement point / Tooth and root		Mean	SD	Mean	SD	p-value	Effect size (Partial Eta Squared)
M1
	First molar (right mesial)	2.16	0.61	1.76	0.53	0.167	0.004
	First molar (right distal)	1.96	0.46	1.7	0.56	0.367	0.002
	First molar (left mesial)	1.81	0.53	1.73	0.58	0.768	0.0002
	First molar (left distal)	1.89	0.49	1.72	0.47	0.508	0.001
	Second molar (right mesial)	2.41	0.64	1.92	0.69	0.109	0.005
	Second molar (right distal)	2.45	0.61	1.96	0.63	0.096	0.006
	Second molar (left mesial)	1.79	0.74	1.64	0.73	0.610	0.001
	Second molar (left distal)	1.79	0.56	1.71	0.71	0.772	0.0002
M2
	First molar (right mesial)	1.77	0.52	1.69	0.49	0.798	0.0001
	First molar (right distal)	1.88	0.51	1.71	0.47	0.552	0.001
	First molar (left mesial)	2.17	0.64	1.81	0.58	0.191	0.004
	First molar (left distal)	1.83	0.64	1.72	0.5	0.676	0.0004
	Second molar (right mesial)	1.71	0.7	1.6	0.69	0.701	0.0003
	Second molar (right distal)	1.78	0.71	1.63	0.64	0.617	0.001
	Second molar (left mesial)	2.43	0.79	1.88	0.69	0.055	0.008
	Second molar (left distal)	2.43	0.71	1.94	0.65	0.088	0.006
M3
	First molar (right mesial)	3.68	2.42	3.68	2.13	0.997	0.000001
	First molar (right distal)	4.05	2.36	3.79	2.14	0.361	0.002
	First molar (left mesial)	4.27	2.36	3.59	1.89	0.014 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.013
	First molar (left distal)	4.65	2.15	3.64	1.75	<0.001 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.032
	Second molar (right mesial)	2.19	2.19	2.08	2.06	0.731	0.0003
	Second molar (right distal)	2.66	2.05	2.51	2.08	0.609	0.001
	Second molar (left mesial)	3.25	2.33	2.08	1.76	<0.001 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.035
	Second molar (left distal)	3.64	2.25	2.68	1.89	0.001 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.023
M4
	First molar (right mesial)	13.19	1.49	12.5	1.78	0.017 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.012
	First molar (right distal)	12.32	1.52	12.1	1.69	0.436	0.001
	First molar (left mesial)	12.98	1.45	12.58	1.74	0.151	0.004
	First molar (left distal)	11.99	1.58	12.24	1.62	0.333	0.002
	Second molar (right mesial)	13.93	1.94	13.07	1.97	0.004 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.017
	Second molar (right distal)	13.94	2.21	13.3	1.79	0.030 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.010
	Second molar (left mesial)	14.25	1.96	13.25	1.75	0.001 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.025
	Second molar (left distal)	14.07	1.96	13.35	1.79	0.013 ^* * Significant at p ≤ 0.05. IAC: inferior alveolar canal, M1: distance between the outer border of the buccal cortical plate and the buccal root surface, M2: distance between the outer border of the lingual cortical plate and the lingual root surface, M3: closest distance between the IAC and the root apex, M4: total bone width, including the root.	0.013

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[1] Corresponding Author: Marwa Sharaan. E-mail: marwaelsayedsharaan@gmail.com