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Background/purpose: Knowledge of root canal anatomy is important for dental practice and for identifying features of anthropological significance. Three-rooted permanent mandibular molars are considered an anatomical variant of the Mongoloid race. This study aimed to determine the prevalence of three-rooted primary mandibular first molars in Taiwanese subjects.Methods: Vertical bite-wing radiographs of 227 subjects, which had been obtained previously in the Department of Pediatric Dentistry, Taichung Veterans General Hospital, Taichung, Taiwan, from January 2004 to December 2007, were screened retrospectively. Images of 121 subjects [54 boys and 67 girls; mean age (range), 5.8 (2.4-10.4) years] who had bilateral primary mandibular first molars were studied. The sex, symmetry and frequency of occurrence of three-rooted primary mandibular first molars were recorded and statistically analyzed.Results: The overall prevalence of subjects with three-rooted primary mandibular first molars was 5.0% (6/121), and 83.0% of the molars were unilateral. The prevalence of teeth that showed an extra root among all teeth examined was 2.9% (7/242). Such prevalence did not differ significantly between the right and left sides of the mandible, bilateral and unilateral, or with sex.Conclusion: The data presented here indicate that approximately 5% of Taiwanese subjects had a threerooted mandibular primary first molar and 80% of such teeth occurred unilaterally. Dentists should take into account the prevalence of these three-rooted variants in primary mandibular first molars among Taiwanese patients during their daily endodontic and exodontic procedures. [ABSTRACT FROM AUTHOR]

The retromolar canal is an anatomical variation that occurs in the mandibular bone. The retromolar canal typically originates in the mandibular canal on the distal side of the third molar and extends forward and upward to the retromolar foramen (RMF), which contains the neurovascular bundle. Accidentally damaging the neurovascular bundle in the retromolar canal during the extraction of the third molar, dental implant surgery, or maxillofacial orthognathic surgery may lead to subsequent complications such as incomplete local anesthesia, paresthesia, and bleeding during operation. The objective of this study was to investigate the prevalence of the RMF in the Taiwanese population in a medical center by using dental cone-beam computed tomography (CBCT) and to identify the position of the RMF in the mandibular bone. The dental CBCT images for the mandibular bone of 68 hemi-mandible were uploaded to the medical imaging software Mimics 15.1 to determine the prevalence of the RMF in the Taiwanese population and the three positional parameters of the RMF in the mandibular bone: (1) The diameter of the RMF, (2) the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the second molar, and (3) the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal. Seven RMFs were observed in the 68 hemi-mandibles. Thus, the RMF prevalence was 10.3%. In addition, the diameter of the RMF was 1.41 ± 0.30 mm (mean ± standard deviation), the horizontal distance from the midpoint of the RMF to the distal cementoenamel junction of the the second molar was 12.93 ± 2.87 mm, and the vertical distance from the midpoint of the RMF to the upper border of the mandibular canal below second molar was 13.62 ± 1.3487 mm. This study determined the prevalence of the RMF in the Taiwanese population in a medical center and its relative position in the mandibular bone. This information can provide clinicians with a reference for posterior mandible anesthesia and surgery to ensure medical safety.

This study determined the prevalence of permanent three-rooted mandibular first molars and their morphology among a Taiwanese population by using cone-beam computed tomography (CBCT). Images from 744 patients were screened to obtain 123 samples for this study. All permanent mandibular first molars were evaluated in axial sections from the pulpal floor to the apices of the roots to determine the number of roots. The interorifice distances from the distolingual (DL) canal to the mesiobuccal (MB) and distobuccal (DB) canals were also estimated. The prevalence of permanent three-rooted mandibular first molars was 33.33%, with a bilateral incidence of a symmetrical distribution of 53.65%. There was a significantly greater incidence of three-rooted teeth on the right side of the mandible than on the left, but gender did not show a significant relationship with this variant prevalence.The mean interorifice distances from the DL canal to the DB, MB, and ML canals of the permanent three-rooted mandibular molars were 2.7, 4.4, and 3.5 mm, respectively. The high prevalence of the DL root in permanent mandibular first molars among the Taiwanese (Chinese) population and estimations of the interorifice distance of such teeth might be useful for successful endodontic treatments.