|6. BRIEF RESUME OF THE INTENDED WORK.
6.1 NEED FOR THE STUDY.
Successful root canal treatment depends on adequate cleaning and filling of the root canal system. However, in order to achieve this, it is imperative that the operator has detail knowledge of the root canal morphology of each individual tooth being treated.1
Conventional radiography has traditionally been used in the various stages of root canal treatment. However, conventional radiography may demonstrate the main feature, it is unlikely to show the complexities of root canal anatomy. Previous studies have suggested that radiographic images are not reliable in the detection of multiple canals. In comparison the technique of clearing teeth has been of considerable importance in studying the anatomy of the root canal system because unlike radiographic images, it gives a three dimensional view of the pulp cavity in relation to the exterior of the teeth and allows a thorough examination of the pulp chamber and root canals.1
6.2 REVIEW OF LITERATURE
In a study conducted in Ugandan population 500 extracted permanent maxillary molars were studied using clearing technique.
This study revealed that 95.9% of maxillary first molars had separate roots. A type I canal configuration was the most frequent in all the roots of both the first and second molars.2
A study was carried out on 83 recently extracted permanent maxillary molars using clearing and radiographic technique. Two examiners examined the radiographs. The kappa values for the agreement between the radiographic examiners A & B and the clearing technique and between the two examiners for the number of roots were 0.60, 0.64 and 0.53 for the root canal type.1
A study on 268 extracted maxillary first molar collected from Thai population was conducted using clearing technique. This study revealed all the maxillary first and second molars had separate roots. Majority of the distobuccal (98.1% -100%) and palatal (100%) roots had type I canals. Over half of the mesiobuccal roots of first (65%) and second (55%) molars had two canals.3
The root canal systems of a sample of 30 mandibular and 30 maxillary first permanent molar teeth extracted from South Asian Pakistanis were studied using a clearing technique. The mesial roots of the mandibular molar teeth typically presented with two canals (97%) of type II, IVor VI configuration. 50% of distal roots presented with two canals. In maxillary molar 53% of mesial root presented with two canals of type I or type V. 4
In a study 72 extracted maxillary molars were root canal treated. The mesiobuccal roots of these samples were rendered transparent using a clearing technique. The results demonstrated that 52.3% of first and 40% of second molars had two canals obturated in the mesiobuccal root. After clearing the same roots, the presence of mesiopalatal canals rose to 80.9% and 66.6% respectively.5
A study was conducted on 208 clinical cases indicated for root canal treatment of maxillary first molar. Surgical telescopes, headlamps and modified access preparation were used clinically to aid in the search for mesiolingual canals in the mesiobuccal roots. Of these, 66 (31.7%) had two separate apical foramina and 82 (39.4%) had two canals that joined. In 60 (28.9%) cases only one canal was located.6
6.3 OBJECTIVE OF THE STUDY.
1) Assessment of number of roots and root configuration of maxillary first molars
2) Incidence of root canals and their configuration in maxillary first molars
7. MATERIALS AND METHOD:
7.1 SOURCE OF DATA.
200 extracted maxillary first molars will be collected from the Department of Oral and Maxillofacial Surgery of P.M.N.M Dental College, Bagalkot.
7.2 METHOD OF COLLECTION OF DATA.
A total of 200-extracted permanent maxillary first molar will be included in the present study. All the specimens will be mounted and standard periapical radiographs will be taken after extraction from a buccolingual and mesiodistal direction. The specimens will be then decoronated, pulp tissue will be removed by immersion in 5% sodium hypochlorite. Indian ink will be then injected into root canal system .The teeth will be then demeneralised in 10% nitric acid and then cleared using methylsalicylate and the cleared teeth will be examined using dissecting/stereomicroscope. The data relating to number of roots, root configuration, number of root canals and canal configuration will be recorded. Two independent trained endodontist will also examine the radiographs for the same features as studied using clearing technique.
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTIONS TO BE CONDUCTED ON PATIENTS OR OTHER HUMAN OR ANIMALS? IF SO, PLEASE DESCRIBE BRIEFLY.
7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION IN CASE OF 7.3?
1.O.E.Omer, R.M.Al Shalabi, N.Jennings, J.Glennon and N.M.Claffey.A
Comparison between clearing and radiographic techniques in the study of root canal anatomy of maxillary first and second molars. Int Endod J 2004; 37:291-296.
2.C.M.Rwenyonyi, A.M.Kutesa, L.M.Muwazi and W.Buwembo: Root and canal morphology of maxillary first and second permanent molar teeth in a Ugandan population. Int Endod J 2007; 40:679-683.
3.A.M.Alavi, A.Opasanon, Y.L.Ng and K.Gulabivala: Root and canal morphology of Thai maxillary molars. Int Endod J 2002; 35:478-485.
4.F.Wasti, A.C.Shearer and N.H.F.Wilson: Root canal systems of the mandibular and maxillary first permanent molar teeth of South Asian Pakistanis.Int Endod J 2001; 34:263-266.
5.N.IMURA, G.I.HATA, T.TODA, S.M.OTAN, M.I.R.C.FAGUNDES .Two canals mesiobuccal roots of maxillary molars. Int Endod J 1998; 31:410-414.
6.Howard M.Fogel, Marshall D.Peikoff, William H.Christie: Canal Configuration in the mesiobuccal root of the maxillary first molar: A clinical study. J Endod 1994; 20(2): 135-137.