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• Evaluation of mandibular and maxillary second molar root canal anatomy in a Turkish subpopulation using CBCT: comparison of Briseno-Marroquin and Vertucci classifications
  Hüseyin Gürkan Güneç, İpek Öreroğlu, Kemal Çağlar, Kader Cesur Aydin
  BMC Medical Imaging.2025;[Epub]     CrossRef
• Frequency of C-Shaped Root Canals in Permanent Mandibular Second Molars in a Sample of Pakistani Population using Cone Beam Computed Tomography
  Syed Nabeel Ahmed, Muhammad Mansoor Majeed, Sakina Kazmi, Muhammad Omar Ansari
  Pakistan Journal of Health Sciences.2024; : 109.     CrossRef
• ANÁLISE DAS VARIAÇÕES ANATÔMICAS DE CANAIS C-SHAPED NOS MOLARES INFERIORES: UMA REVISÃO INTEGRATIVA DA LITERATURA
  Larissa Eulália Pereira, Thayana Karla Guerra Lira dos Santos
  Revista Contemporânea.2024; 4(5): e4264.     CrossRef
• External Validation of the Effect of the Combined Use of Object Detection for the Classification of the C-Shaped Canal Configuration of the Mandibular Second Molar in Panoramic Radiographs: A Multicenter Study
  Sujin Yang, Kee-Deog Kim, Yoshitaka Kise, Michihito Nozawa, Mizuho Mori, Natsuho Takata, Akitoshi Katsumata, Yoshiko Ariji, Wonse Park, Eiichiro Ariji
  Journal of Endodontics.2024; 50(5): 627.     CrossRef
• A Cone‐Beam Computed Tomography Evaluation of C‐Shaped Canal Configuration in Maxillary Molars Among an Iranian Population
  Nafiseh Nikkerdar, Mohammad Moslehi, Amin Golshah, Mario Dioguardi
  International Journal of Dentistry.2024;[Epub]     CrossRef
• Root and canal morphology of mandibular second molars in an Egyptian subpopulation: a cone-beam computed tomography study
  Shehabeldin Mohamed Saber, Mohammed abou El Seoud, Shaimaa Mohamed Abu el Sadat, Nawar Naguib Nawar
  BMC Oral Health.2023;[Epub]     CrossRef
• Comprehensive evaluation of root and root canal morphology of mandibular second molars in a Saudi subpopulation evaluated by cone-beam computed tomography
  Moazzy I. Almansour, Saad M. Al‑Zubaidi, Abdulmjeed S. Enizy, Ahmed A. Madfa
  BMC Oral Health.2022;[Epub]     CrossRef
• Assessment of C-Shaped Canal Morphology in Mandibular and Maxillary Second Molars in an Iraqi Subpopulation Using Cone-Beam Computed Tomography
  Kazhan Abdalrahman, Ranjdar Talabani, Sara Kazzaz, Dlsoz Babarasul, Berndt Koslowski
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• Cone-beam computed tomography evaluation of C-shaped root canal system in mandibular second molars in kuwaiti sub-population
  AbdullahJassim Alenezi, Saad Al-Nazhan, Nassr Al-Maflehi, MazenA Aldosimani
  Saudi Endodontic Journal.2022; 12(3): 283.     CrossRef
• Prevalence and morphology of C‐shaped and non‐C‐shaped root canal systems in mandibular second molars
  T Fenelon, P Parashos
  Australian Dental Journal.2022;[Epub]     CrossRef
• Evaluation of C-shaped canals in mandibular second molars of a selected patient group using cone beam computed tomography: prevalence, configuration and radicular groove types
  Sema Sönmez Kaplan, Tuna Kaplan, Güzide Pelin Sezgin
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• Prevalência estimada de canais “C- Shaped”: Uma revisão sistemática e meta-análise
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• Preferred Reporting Items for Epidemiologic Cross-sectional Studies on Root and Root Canal Anatomy Using Cone-beam Computed Tomographic Technology: A Systematized Assessment
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• Clinical and radiological assessment of the anatomical and topographic structure of the root canals of teeth in patients of different age groups
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• Predicting early endodontic treatment failure following primary root canal treatment
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  BMC Oral Health.2024;[Epub]     CrossRef
• Factors Influencing Non-Surgical Root Canal Treatment Outcomes in Mandibular Second Molars: A Retrospective Cone-Beam Computed Tomography Analysis
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• Retrospective Assessment of Healing Outcome of Endodontic Treatment for Mandibular Molars with C-shaped Root Canal
  Kishore Kumar Majety, Basanta Kumar Choudhury, Anika Bansal, Achla Sethi, Jaina Panjabi
  The Journal of Contemporary Dental Practice.2017; 18(7): 591.     CrossRef

Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

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• Exploring Technological Progress in Three-Dimensional Imaging for Root Canal Treatments: A Systematic Review
  Kanwalpreet Kaur, Ravinder S. Saini, Sunil Kumar Vaddamanu, Shashit Shetty Bavabeedu, Vishwanath Gurumurthy, Shan Sainudeen, Vinod Babu Mathew, Shafait Ullah Khateeb, Aida Mokhlesi, Seyed Ali Mosaddad, Artak Heboyan
  International Dental Journal.2025; 75(2): 1097.     CrossRef
• Root Canal Treatment of Oehlers Type III Dens Invaginatus in Maxillary Lateral Incisor and Remote Sinus Tract Using Dental Surgical Microscope and Cone-Beam Computed Tomography
  Rie Fujii, Tomohiro Asai, Masashi Yamada, Ryo Sako, Yoshiki Tamiya, Masahiro Furusawa
  The Bulletin of Tokyo Dental College.2023; 64(2): 67.     CrossRef
• CBCT and Micro-CT analysis of the mandibular first premolars with C-shaped canal system in a Chinese population author
  Yimeng Zhang, Xunben Weng, Yu Fu, Xuekai Qi, Yihuai Pan, Yu Zhao
  BMC Oral Health.2023;[Epub]     CrossRef

Mandibular second molars have many variations in canal configuration. Technical modifications in cleaning, shaping and obturation are required. The purpose of this study was to investigate the root canal anatomy of mandibular second molars. 86 teeth of 85 patients were accessed and evaluated with taking radiographs for working length determination. 27 teeth(31.4%) had C-shaped canals, 43 teeth(50%) had 3 canals, 11 teeth(12.7%) had 4 canals, 5 teeth(5.8%) had 2 canals. Incidence of C-shaped canal was 31.7% in male and 31.1% in female. 30.9% of left mandibular second molar and 31.8% of right mandibular second molar showed C-shaped canals.

C-shaped canals are known to present a complex canal anatomy with numerous fins connecting individual canals, thus requiring supplementary effort to accomplish a successful root canal treatment. This study examined the frequency of the C-shaped mandibular second molars and interrelation between the clinical records and radiographs to recognize them treated in the Department of Conservative Dentistry of the Chosun University Dental Hospital during a six-year period (1998 - 2004). This study reviewed the clinical records of 227 patients who underwent root canal treatment of the mandibular second molars. After opening the chamber, those cases with C-shaped orifices in the pulpal floor were selected, and the C-shaped root canal types were classified according to Melton's criteria. Three experienced dentists evaluated the radiographs of the C-shaped mandibular second molar on a viewer using a magnifying glass in order to determine if the root apex was fused or separated, the distal root canal was either centered or mesial shifted in the distal root, and if there was bilateral symmetry in a panorama. In conclusion, there is a high frequency of C-shaped mandibular second molars in Koreans. Simultaneous interpretation of the root shape and distal root canal using the preoperative, working length and post-treatment radiographs is important for diagnosing a C-shaped mandibular second molar.

Citations

Citations to this article as recorded by  

• An evaluation of canal curvature at the apical one third in type II mesial canals of mandibular molars
  Hye-Rim Yun, Dong-Kyun Lee, Ho-Keel Hwang
  Restorative Dentistry & Endodontics.2012; 37(2): 104.     CrossRef
• A retrospective study on incidence of C-shaped canals in mandibular second molars
  Hee-Sun Kim
  Journal of Korean Academy of Conservative Dentistry.2009; 34(4): 346.     CrossRef

The C-shaped canal system is an anatomical variation mostly seen in mandibular second molars, although it can also occur in maxillary and other mandibular molars. The main anatomical feature of C-shaped canals is the presence of fins or web connecting the individual root canals. The complexity of C-shaped canals prevents these canals from being cleaned, shaped, and obturated effectively during root canal therapy, and sometimes it leads to an iatrogenic perforation from the extravagant preparation.

The purpose of this study was to provide further knowledge of the anatomical configuration and the minimal thickness of dentinal wall according to the level of the root.

Thirty extracted mandibular second molars with fused roots and longitudinal grooves on lingual or buccal surface of the root were collected from a native Korean population. The photo images and radiographs from buccal, lingual, apical direction were taken. After access cavity was prepared, teeth were placed in 5.25% sodium hypochlorite solution for 2 hours to dissolve the organic tissue of the root surface and from the root canal system. After bench dried and all the teeth were embedded in a self-curing resin. Each block was sectioned using a microtome (Accutom-50, Struers, Denmark) at interval of 1 mm. The sectioned surface photograph was taken using a digital camera (Coolpix 995, Nikon, Japan) connected to the microscope. 197 images were evaluated for canal configurations and the minimal thickness of dentinal wall between canal and external wall using' Root Thickness Gauge Program' designed with Visual Basic.

The results were as follows:

1. At the orifice level of all teeth, the most frequent observed configuration was Melton's Type C I (73%), however the patterns were changed to type C II and C III when the sections were observed at the apical third. On the other hand, the type C III was observed at the orifice level of only 2 teeth but this type could be seen at apical region of the rest of the teeth.

2. The C-shaped canal showed continuous and semi-colon shape at the orifice level, but at the apical portion of the canal there was high possibility of having 2 or 3 canals.

3. Lingual wall was thinner than buccal wall at coronal, middle, apical thirds of root but there was no statistical differences.