CBCT based investigation of frequency of Middle Mesial Canal in Mandibular First Molars of Saudi Sub-population

CBCT study on Middle Mesial Canal

  • Ayman M. Abulhamael Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, P.O. Box 80209, Jeddah 21589, Saudi Arabia
  • Muhammad Qasim Javed College of Dentistry, Qassim University
  • Sobia Hassan Department of Periodontology, Islamic International Dental College and Hospital, Riphah International Uni-versity, Islamabad 44000, Pakistan
  • Sundus Atique College of Dental Medicine, Qatar University, QU Health, Doha 2713, Qatar
  • Syed Rashid Habib Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, King Abdullah Road, P.O. Box 60169, Riyadh 11545, Saudi Arabia
Keywords: Cone beam computed tomography,, Endodontics, Mandibular molars,, Middle mesial canal


Objective: One key factor in determining endodontic treatment outcome is the clinicians’ comprehension of tooth anatomy, as missed canals may harbor bacteria ultimately leading to apical periodontitis. The study aimed to investigate the prevalence of middle mesial canal (MMC) in Mandibular first molars (MFMs) of Saudi subpopulation.

Methods: The cross-sectional retrospective study was conducted at Qassim University Dental College from June to August 2023. Overall, 302 CBCT images with 604 bilateral lower first molars were examined by two calibrated assessors. The existence of MMC was noted. The data were coded, and analysis was done in SPPS-24. The reliability of inter-evaluator and intra-evaluator agreement for detecting MMC were estimated using Cohen’s kappa.

Results: The patients’ average age was 30.95±11.61years. The sample’s female to male ratio was 1:1.75. The overall frequency of MMC was 14.2%. The differences in the frequency of MMC on the basis of gender, quadrants and age groups were found to be insignificant. Inter-evaluator and intra-evaluator reliability was noted to be 0.78 and 0.74, depicting acceptable reliability.

Conclusions: The MMC is an uncommon occurrence with rare bilateral presentation in MFMs of Saudi population. Endodontists performing endodontic treatment in such subjects should mindfully investigate inter mesiobuccal- mesiolingual canals area for locating, negotiating, and managing any present MMC’s.

doi: https://doi.org/10.12669/pjms.40.7.9101

How to cite this: Abulhamael AM, Javed MQ, Hassan S, Atique S, Habib SR. CBCT based investigation of frequency of Middle Mesial Canal in Mandibular First Molars of Saudi Sub-population. Pak J Med Sci. 2024;40(7):1372-1377. doi: https://doi.org/10.12669/pjms.40.7.9101

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

How to Cite
Abulhamael , A. M., Javed, M. Q., Hassan, S., Atique, S., & Habib, S. R. (2024). CBCT based investigation of frequency of Middle Mesial Canal in Mandibular First Molars of Saudi Sub-population: CBCT study on Middle Mesial Canal. Pakistan Journal of Medical Sciences, 40(7). https://doi.org/10.12669/pjms.40.7.9101
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