Prevalencia y clasificación de istmos en primeros molares inferiores evaluados mediante tomografía computarizada de haz cónico. Tacna, Perú (2020-2023)

Abstract

Introduction: The success of root canal treatment largely depends on the professional’s solid understanding of the anatomical variability and morphology of root canals. This includes accurately identifying various anatomical structures, such as accessory canals, apical deltas, and, equally importantly, the presence of isthmuses.

Methodology: 164 Cone Beam Computed Tomography (CBCT) images were analyzed with a field of view (FOV) of 16x10, covering a total of 328 teeth, which were randomly selected from the X-ray Tomographic Center. The NNT Viewer software was used to perform the analysis, and all teeth were evaluated in the three planes: sagittal, axial, and coronal. The chi-square statistical test was applied to determine the association between the proposed variables.

Results: The prevalence of isthmuses in mesial roots of lower first molars according to the Hsu & Kim classification for tooth 36 was 64.6% and for tooth 46 it was 69.5%, the most frequent isthmuses according to location are found at 3 mm and 1 mm represented by type V (64.9% and 80.7% respectively).

Conclusions: The findings of this study confirm the high prevalence of isthmuses in mandibular first molars in a population from Tacna, Peru, with a marked predominance of Type V (Hsu & Kim classification). These results highlight the importance of developing advanced clinical protocols to optimize the treatment of complex anatomical structures and exploring the impact of technologies such as cone-beam computed tomography in diverse populations.