Anatomic Study of Mandibular Posterior Teeth Using Cone-beam Computed Tomography for Endodontic Surgery

Introduction: The present study aimed to anatomically assess mandibular posterior teeth using cone-beam computed tomographic (CBCT) imaging for endodontic surgery. Methods: A total of 170 CBCT scans were evaluated for anatomic variations of mandibular posterior teeth. All the scans were obtained using a Planmeca Promax CBCT unit (Planmeca, Helsinki, Finland) with exposure settings of 90 kVp, 12 mA, 12 seconds, and 0.3-mm resolution. All CBCT images were reconstructed by Romexis Viewer 3.8.2. software (Planmeca) on a 16 inch LCD monitor (22MP47HQ; LG, Seoul, South Korea), and axial, coronal and sagittal views were evaluated. Results: The thickest buccal cortical plate was observed over the distal root of second molars (12.30 mm) among the molar teeth and over the second premolar root (5.41 mm) among the premolar teeth. The thinnest buccal cortical plate was observed over both the first and second premolar roots (0.42 mm) and over the mesial root of the first molar (0.62 mm) tooth. A 20.38-mm section was removed for surgical access during buccal resection of the distal root of the left second molar, and the closest distance from the apex to the inferior alveolar canal was 0 mm. Conclusions: Adequate knowledge of the anatomic dimensions of teeth and their surrounding structures is imperative for endodontic surgery. Information concerning the root thickness of mandibular posterior teeth at the site of root resection (apical 3 mm), buccal cortical plate thickness, and the distance from the apex of each tooth to the inferior alveolar canal and mental foramen can guide the surgeon before and during surgery.