Ricerc@Sapienza

Aim To investigate in vivo the complexity of canals
within mesial roots of mandibular molars using 3D
EndoTM software linked to CBCT images.
Methodology The CBCT images of 100 mandibular
first molars were analysed using the 3D EndoTM
software. The number of canals in the mesial roots,
the presence of apical confluences, the canal lengths
and the canal configurations using Vertucci’s classification
were evaluated in buccolingual (BL) and
mesiodistal (MD) views. The software allowed the
visualization of canal trajectories in three dimensions
using a coloured outline, which was used to develop
a new objective scoring system to provide an overall
assessment of canal complexity. Data were analysed
statistically using ANOVA and t-tests with the significance
set at P < 0.05.
Results Vertucci type IV canals were found in 44% of
the cases, whilst 54% were type II. The mean distance
from the apical foramen to the orifice was 13.15 mm
(1.21) and that between a confluence and the foramen,
2.81 mm (1.13). The number of curvatures and the
canal complexity scores in the MD view were significantly
higher than in the BL view (P < 0.05). The scores
were not directly correlated to the canal (MB versus ML),
to the canal length or to the presence of confluences.
Conclusions 3D Endo software features the automatic
detection and measurement of several anatomical
canal parameters, and is a promising tool for the
study of canal complexity in vivo. The unpredictable
anatomy of the mesial roots of mandibular molars
highlights the value of a three-dimensional preoperative
evaluation of each case. The proposed scoring
system aims to provide the clinician with an overall
assessment of canal complexity.