Root and canal morphology of the mesiobuccal and distal roots of permanent first molars in a Kuwait population--a clinical study.

AIM: To identify the number of roots and canal configurations in permanent first molars of the indigenous Kuwaiti sub-population and compare them against a similar group of non-Kuwaiti population in different age groups and gender, and to determine the frequency of a second canal in the mesiobuccal root of maxillary first molars and distal root of mandibular first molars that could be located and treated in routine practice without using magnification or special lighting conditions. METHODOLOGY: A total of 220 permanent first molar teeth of patients scheduled for root canal treatment over a period of 1 year were included. Patients were identified and grouped according to their nationality as Kuwaiti and non-Kuwaiti (which included Filipinos, Indonesian Indians, Srilankans, Egyptians, Saudi Arabians and Syrians). In both nationality groups, patients were successively distributed into four groups based on their age. The first age group included patients below 20 years, the second 21-30 years, the third 31-40 years and the fourth were over 40 years. The first three groups comprised of 15 male and 15 female patients whilst the fourth group had 10 patients of each gender. Teeth with open apices, resorptions and calcification were excluded from the study. The teeth included were both clinically and radiographically examined for number of roots, the canal configuration and the presence of the additional mesiobuccal and distal canals and recorded. The simplified classification of canal configurations proposed by Weine was utilized. RESULTS: The incidence of a second canal in the mesiobuccal (MB) root of maxillary first molars and the distal root of mandibular first molars was not influenced significantly by nationality and gender. All the 110 maxillary first molars treated had three roots; 58% of MB root had one canal and 42% had two canals. The majority of the mesial roots had Weine type II canal configuration when the second mesiobuccal canal was present. All distobuccal and palatal roots had a single or type I canal configuration. Of the 110 mandibular first molars that were treated, 96% had two roots and 4% had three roots. When present, the third root was located either buccal or lingual to the main distal root. Overall 51% of the single distal roots had one canal whilst 49% had two canals. The mesial root frequently had a Weine type II canal configuration as did the distal root when a second canal was present. Pearson's correlation analysis of both molars revealed a significant (P < 0.05) negative correlation (r = -0.274, r = -0.144) between age and number of canals as well as the type of canal. CONCLUSIONS: The incidence of a second canal in distal roots of permanent mandibular first molars was 49% in the Kuwaiti population and this was similar to other Asian ethnic populations. Adopting modified access and troughing procedures revealed a 42% frequency of MB2 canals in maxillary first molars. The incidence of a second canal in both mesiobuccal roots of maxillary molars and distal roots of mandibular molars decreased significantly with age; no differences were noticed amongst the nationalities and gender studied. The possibility of extra roots should be anticipated in mandibular molars.

Frequency of endodontic treatment in Kuwait: radiographic evaluation of 846 endodontically treated teeth.

A retrospective study was conducted to evaluate the radiographic films of 846 endodontically treated teeth at Benied Al Ghar Dental Center in Kuwait. The most frequently treated tooth was the mandibular first molar (17.4%). The number, percentage, and distribution of the roots, root canals, and apical foramina were reported by individual tooth. The clinical findings were compared to the results of previously related in vitro and in vivo studies.

Misdiagnosis and mismanagement of a nasopalatine duct cyst and its corrective therapy. A case report.

A case is presented in which a nasopalatine duct cyst was misdiagnosed. Its subsequent mismanagement was further compounded with improper endodontic therapy. It was finally managed by corrective endodontic and surgical therapy.

Unusual foreign objects in the root canal.

Removal of foreign objects from the root canal is often a very difficult procedure. The procedure is even more complicated if the foreign body is unusual. To cases are presented in which the foreign objects were removed with minimal loss to the intracanal space.

Healing of large periapical lesions following nonsurgical endodontic therapy: case reports.

The cases of two patients with large cystlike periapical lesions are presented. The lesions formed as a result of trauma to the associated teeth. Following conservative nonsurgical endodontic treatment, there was complete resolution of the lesions. These results suggest that the largeness of a periapical lesion does not mandate its surgical removal and that even cystlike periapical lesions heal following conservative endodontic therapy.

Cutaneous sinus tracts of dental origin to the chin and cheek: case reports.

Cutaneous sinus tract of dental origin is the most common among the many types of sinus tracts that are formed on the face and neck. Because these lesions are often diagnosed incorrectly, they are also treated ineffectively. Cases of cutaneous sinus tract on the chin and cheek are presented, and a simple way to diagnose this lesion is described. In both patients, the lesion was completely resolved following nonsurgical endodontic therapy.