Avaliação anatômica de pré-molares e incisivos mandibulares por imagens de tomografia computadorizada de feixe cônico

Abstract

To increase the chances of successful endodontic treatment, it is essential to know the morphology of roots and root canals, in addition to their anatomical variations. The objective of this study was to evaluate, through cone-beam computed tomography (CBCT) exams, the morphology of lower premolars and incisors and to verify whether the presence of complex anatomy in incisors is associated with the presence of complexity in premolars, as a function of gender and age. CBCT images of 493 individuals, regardless of gender, were selected and evaluated by three examiners. Lower premolars and incisors were classified according to Vertucci (1984) and Wu et al. (2017). Intra- and inter-examiner reproducibility was calculated using the weighted Kappa test. The association between the root morphology of incisors and premolars was evaluated using the chi-square test. To verify whether the root anatomy of the premolars was able to predict the root anatomy of the incisors, as a function of gender and age, a mixed predictive model was calculated, with a significance level of 5%. It was observed that 72% of the central incisors had 1R1C (1 root and 1 canal) and 28% 1R2C according to the classification by Wu et al. (2017) and 72% were Vertucci type I, 27% type III and 1% type IV (1984). Regarding lateral incisors, 72% had 1R1C, 28% 1R2C; 71% were type I, 1% type II, 27% type III and 1% type IV. Among the first premolars, 71% had 1R1C, 26% 1R2C, 3% 2R2C; 71% were type I, 18% type III and 11% type V. Among second premolars, 1R1C was found in 93%, 1R2C in 5%, 2R2C in 1%; 94% were type I, 3% type III and 3% type V. The variables that influenced the presence of complicated morphology in central and lateral incisors were: 2nd premolar, 1st premolar and sex (male) of the patient, and they increased the chance of the central incisors having a complicated morphology by 2.16, 1.69 and 0.47 times, respectively. Regarding the lateral incisors, these chances increase by 1.86, 1.92 and 0.69 respectively. It was concluded that the presence of complex anatomy in the incisors was associated with the presence of complexity in the premolars and with the sex of the individuals.