PREVALENCE OF MIDDLE MESIAL CANAL IN MANDIBULAR FIRST MOLAR: A CONE BEAM COMPUTED TOMOGRAPHY STUDY

Abstract

OBJECTIVE:To determine the prevalence of middle mesial canal in the mandibular first molar using cone beam computed tomography in patients presenting outpatient department of Bakhtawar Amin Dental Hospital.

MATERIALS AND METHODS:Study design was Descriptive cross-sectional study atOut Patient Department of Operative Dentistry, BADCH Multan with duration of 6 months. Sampling technique used was Consecutive non-probability sampling. Sample size was calculated using the findings of Tahmasbi et al [3] who reported that prevalence of middle mesial canal in mandibular first molar was 16.4%. Sample size was calculated using the WHO sample size calculator. Confidence level set at 95%. Margin of error was 5% with sample size of21l. Sample selection was done with inclusion criteria as intact crowns, patient with ages between l5-60 years ofboth genders, teeth diagnosed with irreversible pulpitis, (deep caries lesion causing sharp, severe and radiating pain of longer duration assessed clinically and radiographically as radiolucency encroaching on the pulp).Data Analysis done by using version 25.0 SPSS for Windows, Frequency and percentages were calculated for middle mesial canal and genders. The p < 0.05 was considered statistically significant.

RESULTS:The study revealed no statistically significant difference in MMC prevalence based on gender, with 9 male patients (52.9%) and 8 female patients (47.1%) exhibiting the canal (p > 0.05). A significant association was observed with age, as both the young adult group (15-30 years) and the middle-aged adult group (31-45 years) showed a higher prevalence of MMC compared to the elderly group (46-60 years) and overall prevalence of the MMC was found to be 8.1%.  The decrease in prevalence in the elderly group is likely due to secondary dentin deposition with age, resulting in narrowing and potential obliteration of such additional canals. Morphologically, the confluent type was the most common configuration.

CONCLUSION:The Middle Mesial Canal is an anatomical variant in the mandibular first molar within the studied population of South Punjab, Pakistan. Clinicians must maintain a high index of suspicion during endodontic treatment planning. The use of advanced diagnostic tools like CBCT is recommended to ensure the identification and proper management of the MMC. Clinicians must be thoroughly familiar with this variation and employ meticulous exploration techniques to achieve a successful and predictable long-term outcome.