Incidence of three roots and/or four root canals in the permanent mandibular first molars in a Korean sub-population.


Dr. Ove A. Peters: 0000-0001-5222-8718

Document Type


Publication Title

Clinical Oral Investigations









First Page


Last Page


Publication Date



OBJECTIVES: The purpose of this study was to evaluate the prevalence of three-rooted permanent mandibular first molars (PMFMs) with four canals and their morphological characteristics among a Korean population from using cone-beam computed tomography scans (CBCTs).

MATERIALS AND METHODS: Among the 705 CBCTs screened, 472 patient cases possessing at least one PMFM were identified. A total of 780 PMFMs were evaluated in axial section series to determine the number of roots and canals. The incidences of three-rooted PMFMs were compared with regard to gender and location. For distal root(s) with two canals, inter-orifice distances (IOD) between distobuccal and distolingual canals were measured at pulpal floor and furcation levels. The difference of IOD between males and females was also analyzed using chi-square tests.

RESULTS: Among the 472 CBCTs of 225 females and 247 males, 84 females and 107 males were found to have at least one three-rooted PMFM. Among the 780 PMFMs, 191 PMFMs (24.5%, 89 of 397 left and 102 of 383 right) were found to have three roots. The prevalence of distal root(s) with two canals was 34.2% (267 of 780). From the molars with two distal canals, the mean IOD between distobuccal and distolingual canals at the pulpal floor level was 3.1 mm in males and 2.9 mm in females (p = 0.0428).

CONCLUSIONS: The occurrence of three-rooted PMFMs among a Korean population was 24.5% and was higher than other countries and ethnicities. Understanding the prevalence of PMFMs with a distolingual root and/or canal in a Korean population and the IOD between distobuccal and distolingual canals may be useful for successful endodontic treatments.

CLINICAL RELEVANCE: Acknowledgment of potential incidence of three-rooted permanent mandibular first molars with four canals and the distance between two distal canals may increase the success rate of root canal treatment by reducing the missing canal untreated.