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141]

Original Article

The internal root canal morphology of single‑rooted

mandibular canines revealed by micro‑computed
tomography
Marília Fagury Marceliano‑Alves, Carolina Oliveira de Lima, Carla Mendonça Augusto,
Ana Flávia Almeida Barbosa, Adilia Maria Vieira Bruno, Aline Martins Rosa, Ricardo Tadeu Lopes1
Departments of Endodontics and 1Metallurgical and Materials Engineering, Rio de Janeiro Federal University, Rio de Janeiro, Brazil

Abstract
Context: The lack of thorough knowledge regarding morphological and anatomical variations of the root canal system can
result in failure to identify all root canals and lead to inadequate instrumentation and consequent failure of the endodontic
treatment.
Aims: The aim of the study was to evaluate the anatomy of single‑rooted mandibular canines using micro‑computed
tomography (micro‑CT).
Subjects and Methods: Eighty mandibular canines were scanned by micro‑CT to determine anatomic parameters: Vertucci’s
classification, number of lateral canals, roundness, and minor and major diameters. The shape of root canal orifices, volume,
surface area, and convexity structure model index (SMI) were also evaluated.
Analysis Used: The CTAn and CTvol software were used to three‑dimensional and morphometric analysis.
Results: All canals were classified as Vertucci Type I. Lateral canals were verified in 42.4% of the roots, in apical third. The
canal diameters were decreased near the apex. The cross sections at the cementoenamel junction and 1 mm from the apex
were oval in 38.3% and 79.4% of the canals, respectively. The mean canal volumes and surface areas were 11.48 ± 4.41
mm3 ≥ and 67.29 ± 19.18 mm², respectively. The SMI values indicated that mandibular canine was approximately rod like.
Conclusions: The morphology of the root canal of single‑rooted canines varied widely at different root levels.
Keywords: Anatomy; canine; micro‑computed tomography; root canal

INTRODUCTION inadequate instrumentation and consequent failure of

the endodontic treatment.[2] Therefore, the first step in
Successful endodontic treatments depend on achieving a successful endodontic outcome is an exact RCS
complete root canal cleaning and shaping, as well as evaluation and its anatomical variations.[3]
three‑dimensional (3D) hermetic root canal system (RCS)
filling.[1] The lack of thorough knowledge regarding Several techniques have been applied in the study of RCS
morphological and anatomical variations of the RCS can morphology. Traditional methods, such as radiography,
result in failure to identify all root canals and lead to cross‑sectioning, staining and root clearing, scanning
electron microscopy, and stereomicroscopy, are either
Address for correspondence: destructive or provide only two‑dimensional (2D)
Dr. Marília Fagury Marceliano‑Alves, Rua Siqueira Campos, information.[4‑6]
59, Sala 303, Copacabana, Rio de Janeiro, Brazil.
E‑mail: mmarceliano@hotmail.com This is an open access journal, and articles are distributed under the terms
Date of submission : 06.07.2018 of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0
Review completed : 07.08.2018 License, which allows others to remix, tweak, and build upon the work
Date of acceptance : 07.08.2018 non‑commercially, as long as appropriate credit is given and the new
creations are licensed under the identical terms.
Access this article online
Quick Response Code: For reprints contact: reprints@medknow.com
Website:
www.jcd.org.in How to cite this article: Marceliano-Alves MF, de Lima CO,
Augusto CM, Almeida Barbosa AF, Vieira Bruno AM, Rosa AM,
et al. The internal root canal morphology of single-rooted
DOI:
mandibular canines revealed by micro-computed tomography. J
10.4103/JCD.JCD_313_18
Conserv Dent 2018;21:588-91.

588 © 2018 Journal of Conservative Dentistry | Published by Wolters Kluwer - Medknow

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Marceliano‑Alves, et al.: Single‑rooted canines’ morphology by micro‑CT
Micro‑computed tomography (micro‑CT) is a noninvasive,
nondestructive, and reproducible method, considered the
most accurate method for RCS morphology investigations,
and can be applied quantitatively, as well as qualitatively,
for the 3D RCS assessments.[5,7,8]
Some studies[6,9] have reported that mandibular canines
display a highly variable internal canal configuration.
According to Wu et al.,[9] mandibular canines display a high
incidence of oval‑shaped canals, posing a significant challenge
for adequate root canal treatment, since instruments leave
behind untouched recesses in the root canal. In addition,
other factors that can contribute to differences in internal
complexities of the root canal anatomy include ethnic
differences, age, gender, and study design.[1,11]
A great morphological variation in this regard is observed
in the Brazilian population, as it is considered one of the
most heterogeneous populations in the world, with an
important genetic contribution from the following main
continental groups: Europeans, Africans, Asians, and Native
Americans.[12] In this context, the aim of the present study
was to evaluate the root canal morphology of single‑rooted
human mandibular canines in a Brazilian Southeastern
subpopulation by micro‑CT.
SUBJECTS AND METHODS
Sample selection
This study was approved by the local Ethics and Research
Committee. One hundred and thirty extracted human
mandibular canines were evaluated. The roots met the
following inclusion criteria: fully formed apex, the absence
of fractures, and no previous endodontic treatment on the
canines.
Micro‑computed tomography scanning and
analysis
The roots were scanned on a SkyScan 1173 v2 micro‑CT
(Bruker MicroCT, Kontich, Belgium). The X‑ray tube was
operated at 50 kV and 160 µA, using a 1 mm thick aluminum
filter, 320 ms exposure time, 0.8 rotation step, and 360°
rotation. Both the cross‑sectional pixel size and intersection
distance (resolution) were set at 12.1 µm. These acquisition
parameters were used for all scanned specimens. The
acquired projection files were reconstructed into a 3D
dataset using the NRecon software (v1.6.1.0; Bruker, Kontich,
Belgium). Reconstruction parameters included a 50% beam
hardening correction, ring artifact correction of 10, and
input of fixed contrast limits (0–0.05) for all image stacks.
Morphologic canal parameters were recorded (CTAn v.
1.14.4, Bruker‑Microct Kontich, Belgium) and 3D models
of the mesial RCSs were obtained and evaluated (CTVol v.
2.2.1, Bruker‑Microct, Kontich, Belgium). The registered
images were then processed to generate 3D renderings
Journal of Conservative Dentistry | Volume 21 | Issue 6 | November-December 2018
of the external tooth surface and the internal root canal
space. During reconstruction, transparency was adjusted,
so internal morphology could be visualized.
The following parameters were evaluated: number of
canals, root canal configurations according to Vertucci’s
classification,[13] root length and number and location of lateral
canals, the presence of apical delta, perimeter, roundness,
and minor and major diameters at cervical, medium, and
apical thirds and 1 mm from the foramen. The cross sections
of the root canals were classified as round, oval, long oval,
or flattened, according to the minor and major diameters of
the canals 1 mm from the apex, as described previously by
Jou et al.[12] In addition, the number and shape of root canal
orifices at the cementoenamel junction (CEJ) level were also
evaluated, according to Liu et al.[13] and Johnsen et al.[14] The
CTan (Bruker MicroCT, Kontich, Belgium) plug‑in 3D analysis
and morphometric analyses were applied.
The 3D root canal measurements included volume
(mm3≥), surface area  (mm²), and convexity structure
model index (SMI) from the CEJ to the apex and were also
evaluated by the CTan (Bruker MicroCT, Kontich, Belgium).
RESULTS
3D reconstruction of the internal anatomy indicated that
all specimens exhibited a single main root canal. Therefore,
100% of the specimens were classified as Vertucci
Type I [Figure 1a]. The length of the roots measured from
the pulp chamber to the apical foramen ranged from 11.76
to 20.84 mm (15.89 ± 1.96 mm). Lateral canals were
verified in 42.4% of the roots, all present in the apical
third [Figure 1b]; the apical delta was observed in 19% of
canines [Figure 1c].
The results of the 2D (perimeter, roundness, and major and
minor diameter) analysis are detailed in Table 1.
Concerning root canal orifice shapes and types at the
CEJ level, six different orifice shapes were observed,
a b c
Figure 1: Representative three‑dimensional models of
mandibular canines. (a) Vertucci type I, (b) lateral canals,
(c) apical delta
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Marceliano‑Alves, et al.: Single‑rooted canines’ morphology by micro‑CT

namely oval (38.3%), Hourglass (30.1%), bowling pin (15%),
circular (6.8%), fish (5.8%), and kidney (4%). Triangular orifice
shapes were not observed [Figure 2a-f]. Regarding the cross
sections 1 mm from the apex, 79.4% were classified as oval,
19.2% were classified as long oval, and 1.4% as flattened
canals. No round canals were observed.
canines displayed only one main canal and were classified
as Vertucci Type I, similar to the study carried out by
Versiani et al.[8] The length of the roots measured from
the pulp chamber to the apical foramen ranged from
11.76 to 20.84 mm (15.89 ± 1.96 mm), similar with other
studies.[9,21,22]

The mean volume of the mandibular canine canals Lateral canals were verified in 42.4% of the roots, all in
and surface areas was 11.48 ± 4.41 mm3≥ and the apical third. Somalinga Amardeep et  al.[18] observed a
67.29 ± 19.18 mm², respectively. In the present study, the frequency of 12.8% of apical lateral canals by cone‑beam CT
SMI results indicated that the canine root canal geometry analysis, while Versiani et al.[5,16] detected accessory canals
was approximately rod like (SMI = 1.43 ± 1.25). located at the middle (4%) and apical thirds (65%). This
discrepancy between studies may be due to differences
DISCUSSION in populations, evaluation techniques, and/or sample size.
However, these results confirm the evidence that lateral
An accurate knowledge on root‑canal morphology and canals are most prevalent in the apical third in mandibular
its anatomical variations is mandatory for successful root canines.
canal treatment.[5,15-17] The morphology of single‑rooted
mandibular canines was evaluated by micro‑CT. The apical third is considered the most complex RCS
structure, rendering it difficult to shape and clean
It has been reported that the prevalence of type I root completely when lateral canals, apical deltas, and many
canal configurations in mandibular canines ranges from apical foramina are present.[7] Therefore, the findings of
78% to 98%.[18‑20] In this study, all evaluated mandibular the present study reinforce the importance of chemical
disinfection in these regions and the need for additional
Table 1: Morphometric two‑dimensional data disinfection measures such as intracanal medication and
(means±standard deviation) the use of active irrigation methods.
Cervical Medium Apical 1 mm from
forame The root canals of the evaluated mandibular canines
Perimeter (mm) 5.78 (1.29) 4.41 (1.13) 1.29 (0.58) 1.31 (0.38) were wider mesiodistally compared to buccolingually,
Roundness 0.38 (0.13) 0.46 (0.16) 0.73 (0.09) 0.70 (0.13)
Major diameter (mm) 2.3 (0.40) 1.63 (0.46) 0.58 (0.18) 0.43 (0.14)
mainly in the cervical third. The perimeter and major
Minor diameter (mm) 0.87 (0.29) 0.66 (0.16) 0.44 (0.11) 0.30 (0.06) and minor diameter results reflected this morphological
feature, higher in the cervical compared to the middle
and apical thirds [Table 1], similar to the results reported
by Versiani et al.[5,15]

Canals may present different shapes in cross sections at

a b
different root levels in a same tooth.[4] In the present study,
cross sections were evaluated applying three parameters:
at the CEJ level, 1 mm from the apex, and roundness.
In both cross sections, most canines were classified as
displaying oval canals (38.3% and 79.4%, respectively).
c Roundness increased in the apical third [Table 1], indicating
that the apical third was more oval compared to the
middle and cervical thirds, similar to reported by Versiani
et al.[8] Oval‑shaped canals are often poorly cleaned and
disinfected, since rotary instrumentation usually sculpts
a round cross‑sectional shape, which leaves behind
untouched recesses in the extremities of the largest
diameter of the oval canal.[7]

The surface area and volume of the canines were measured

d e f to determine the SMI, which is the change in surface
Figure 2: (a-f) Representative images of canal orifice shapes area with infinitesimal enlargements of the surface when
at cementoenamel junction detected in this study: (a) circular, the change in volume is related to surface area changes.
(b) oval, (c) fish, (d) bowling pin, (e) kidney, and (f) hourglass This 3D parameter, which involves the measurement

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Marceliano‑Alves, et al.: Single‑rooted canines’ morphology by micro‑CT
of surface convexity, is classified as plate (SMI = 0),
cylindrical (SMI = 3), or variable (intermediate values).[9] In
the present study, SMI results indicated that the mandibular
canine root canal geometry was approximately rod
like (SMI = 1.43 ± 1.25), in contrast with the study
carried out by Versiani et al.[5] Thus, discrepancy between
studies, as stated previously, may be due to differences in
populations and/or sample size.
CONCLUSIONS
The root canal of single‑rooted canines evaluated in the
present study was classified as Vertucci type I. However,
canine morphology varied widely at different root
levels. The high frequency of lateral canals in the apical
third (42.2%), apical delta (19%), apical foramen (10%),
and oval‑shaped cross sections at CEJ and 1 mm from the
apex (38.3% and 79.4%, respectively) highlight the anatomic
complexity of mandibular canines.
Acknowledgment
To the Conselho Nacional de Desenvolvimento Científico
e Tecnológico and Coordenação de Aperfeiçoamento de
Pessoal de Nivel Superior, both Brazilian Funding Agencies.
Financial support and sponsorship
This work was supported by Coordenação de
Aperfeiçoamento de Pessoal de Nivel Superior.
Conflicts of interest
There are no conflicts of interest.
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