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Izvestia Journal of the Union of Scientists - Varna. Medicine and Ecology Series

A CBCT study of the root canal system anatomy and bilateral symmetry of maxillary and mandibular molars

Slavena Svetlozarova, Tsvetelina Borisova-Papancheva


The aim of this study is to analyze root canal anatomy and symmetry of maxillary and mandibular first and second molars of the Bulgarian population using cone-beam computed tomography (CBCT) as a diagnostic tool.

A total of 100 patients who required CBCT examination as part of their dental treatment were enrolled in our study. A total of 561 untreated, well-developed maxillary and mandibular molar teeth (139 maxillary first molars, 162 maxillary second molars, 116 mandibular first molars and 144 mandibular second molars) were examined by CBCT to establish the number of root canals and the symmetry in canal anatomy between both sides in the same patient.

Three separate root canals presented normal anatomy of maxillary second and mandibular first and second molars. Maxillary first molars presented in over 60% of the cases with an additional mesio-buccal root canal.

Maxillary first molars were found to be symmetrical in 84% of the patients, whereas maxillary second molars - in 68.5%; 16.3% of the mandibular first and 8.1% of the mandibular second molars showed asymmetry.

The results of the present study reported a high percentage of maxillary first molar teeth with four root canals in the Bulgarian population, as well as percentage of asymmetry between the first and second maxillary and mandibular molar teeth that varied from 8.1-31.5%. These variations of symmetry should be taken into consideration in cases when endodontic treatment of two opposite molars in the same patient is required, because their root canal anatomy can present with significant differences.


CBCT, maxillary molars, mandibular molars, symmetry, root canal anatomy

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