This study aimed to investigate the prevalence of a separate distolingual root and to measure the thickness of the buccal cortical bone in mandibular first molars in Koreans using cone-beam computed tomography (CBCT) images.

High-quality CBCT data from 432 patients were analyzed in this study. The prevalence of a separate distolingual root of the mandibular first molar was investigated. The distance from the distobuccal and distolingual root apices to the outer surface of the buccal cortical bone was measured. We also evaluated the thickness of the buccal cortical bone.

The prevalence of a separate distolingual root (2 separate distal roots with 1 canal in each root; 2R2C) was 23.26%. In mandibular first molars with 2R2C, the distance from the distobuccal root apex to the outer surface of the buccal cortical bone was 5.51 mm. Furthermore, the distance from the distolingual root apex to the outer surface of the buccal cortical bone was 12.09 mm. In mandibular first molars with 2R2C morphology, the thickness of the buccal cortical bone at the distobuccal root apex of the mandibular first molar was 3.30 mm. The buccal cortical bone at the distobuccal root apex was significantly thicker in the right side (3.38 mm) than the left side (3.09 mm) (p < 0.05).

A separate distolingual root is not rare in mandibular first molars in the Korean population. Anatomic and morphologic knowledge of the mandibular first molar can be useful in treatment planning, including surgical endodontic treatment.

The aim of this study was to investigate the relationship between the apical foramen morphology and the length of merged canal at the apex in type II root canal system.

This study included intact extracted maxillary and mandibular human premolars (n = 20) with fully formed roots without any visible signs of external resorption. The root segments were obtained by removing the crown 1 mm beneath the cementum-enamel junction (CEJ) using a rotary diamond disk. The distance between the file tip and merged point of joining two canals was defined as Lj. The roots were carefully sectioned at 1 mm from the apex by a slow-speed water-cooled diamond saw. All cross sections were examined under the microscope at ×50 magnification and photographed to estimate the shape of the apical foramen. The longest and the shortest diameter of apical foramen was measured using ImageJ program (1.44p, National Institutes of Health). Correlation coefficient was calculated to identify the link between Lj and the apical foramen shape by Pearson's correlation.

The average value of Lj was 3.74 mm. The average of proportion (P), estimated by dividing the longest diameter into the shortest diameter of the apical foramen, was 3.64. This study showed a significant negative correlation between P and Lj (p < 0.05).

As Lj gets longer, the apical foramen becomes more ovally shaped. Likewise, as it gets shorter, the apical foramen becomes more flat shaped.