A Systematic Review and Meta-analysis of the Prevalence and Global Distribution of Middle Mesial Canals in Mandibular Molars Identified by CBCT

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2024 May 14

PMID 38743355

Authors

Mahmood Reza Kalantar Motamedi

Mohammad Hosein Amirzade-Iranaq

William N Ha

Affiliations

Soon will be listed here.

Abstract

Objectives: This systematic review and meta-analysis aimed to evaluate the prevalence of middle mesial canal (MMC) in permanent mandibular molars of different populations and regions based on cone-beam computed tomography (CBCT) studies.

Materials And Methods: PubMed, Scopus, Embase, Web of Science, and Open-Grey were searched up to October 2023 according to specific keywords. A hand search was conducted on the references of the included studies and articles from three peer-reviewed journals in endodontics. The main variable of interest was the prevalence of MMC. Additional data such as the total number of included cases, age and country of the population, CBCT device information, voxel size, and field of view details were also extracted. Extracted data were analyzed qualitatively with the JBI quality assessment checklist and quantitatively with STATA software.

Results: Of 32,793 studied teeth, the cumulative prevalence of MMC in both mandibular 1 and 2 molars was 3.11% (95% CI: 2.00-4.44%). The subgroup analysis reveals a prevalence of 4.15% (95% CI: 2.69-5.89%) for mandibular 1 molars and 1.2% (95% CI: 0.2-2.83%) for mandibular 2 molars. The highest prevalence of MMC in 1 molar was attributed to South Asia (11.24%) and Africa (6.61%).

Conclusions: The prevalence of MMC varies among regions. Clinicians should be aware of the potential prevalence of MMC, particularly in mandibular first molars, as a missed MMC could result in endodontic failure.

Clinical Relevance: The presence of MMCs varies in different geographic regions (0% to 29.7%). Clinicians should always look for MMC when doing an endodontic treatment on mandibular molars, as the presence of this canal is not uncommon. We suggest searching for this canal as if searching for the second mesiobuccal canal of maxillary 1st molars.

Citing Articles

Correlation between the Middle Mesial Canal and Furcation Radiolucency in Mandibular Molars.

Karimzadeh M, Shahravan A, Fereidooni R, Ebrahimnejad H, Nekouei A, Arbabi S Iran Endod J. 2025; 20(1):e4.

PMID: 39935867 PMC: 11808327. DOI: 10.22037/iej.v20i1.46099.

Prevalence and morphology of middle mesial canals in mandibular first molars and their relationship with anatomical aspects of the mesial root: a CBCT analysis.

Wang D, Wang R, Xu H, Zhang Q, Guo Y BMC Oral Health. 2025; 25(1):147.

PMID: 39875974 PMC: 11773784. DOI: 10.1186/s12903-025-05533-1.

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