Prevalence of center mesial canal in mandibular molars


Center mesial canals in mandibular first and second molars are a typical prevalence. Understanding the placement and the possibility of center mesial canals being current is vital because it will increase the success price of root canal therapies.

The purpose of this assessment is to find out the prevalence of center mesial canals (MMCs) in mandibular first and second molars globally, utilizing cone beam computed tomography (CBCT) as an evaluation device. This assessment additionally seems to see if components such because the molar’s aspect, age, gender and geographic location of sufferers has an affect on the probability of a center mesial canal to be current.


A assessment protocol was registered within the PROSPERO database which adopted the hottest tips for reporting objects for systematic opinions. Medline/PubMed, Net of science, Scopus, SciELO and Google Scholar databases have been searched utilizing no filters (comparable to no time or language restrictions) between 15.11.22-21.11.22 to keep away from bias. Key phrases and technique have been developed in PubMed and used with different databases with minor adjustments with the intention to get extra related research, whereas duplicates have been eliminated. All included research have been English language and cross-sectional in nature. The research have been high quality assessed independently by the two authors utilizing the Newcastle-Ottawa High quality Evaluation Scale for cross-sectional research – these of moderate-high high quality have been included.  A meta-analysis was undertaken by pooling particular person research’ prevalence charges and calculating the respective odds ratio and confidence intervals (CIs). Assessments of heterogeneity between totally different grouping components (aspect, age, gender and many others.) have been undertaken using the Chi2 and I2 checks. The statistical significance was set at P < .05 for all analyses.


  • 34 research have been included involving 13,349 mandibular first and seven,624 second molars.
  • 21 research have been of excessive qualityand 13 research of average high quality.
  • 27 research reported a MMC prevalence price of 4.4% (95percentCl: 3.5% to five.3%) in mandibular 1st
  • 18 research reported a MMC prevalence of 1.3% (95percentCl: 0.08% to 1.8%) in mandibular 2nd molars.
  • 13 research confirmed a considerably larger MMC prevalence price in 1st molars in comparison with 2nd molars.
  • The affect of gender, age, geographic location, and molar’s aspect was additionally assessed, and no statistical variations have been discovered (see desk under).
Issue  MMC in 1st molars  MMC in 2nd molars 
Males 2.9% 0.8%
Females 3.6% 1.2%
Age <40 11.9% 7.1%
Age >40 10.9% 4.6%
Asia 4.6% 1.0%
Europe 3.4% 1.1%
Africa 10.0%
America 5.4%


The authors concluded: –

    On the idea of considerably good proof stemmed from 33 research of high-to-moderate high quality, the prevalence of MMC in mandibular first molar and, to much less extent, in mandibular second molar is just not unusual, a matter that warrants cautious exploring whereas treating these tooth so as to not lacking this canal. It seems that the prevalence of the MMC in mandibular molars is just not affected by gender, age, molar’s aspect.


The authors registered their assessment with the PROSPERO database and adopted the newest tips for reporting objects for systematic opinions. A number of databases have been searched between 15th and 21st of November 2022. There have been no restrictions within the search, nevertheless, limitations have been nonetheless current. For instance, the authors excluded all non-English language papers through the eligibility evaluation. One other limitation was the truth that lots of the research used have been of Asian and European origin whereas only some have been American and African. No research within the Australian continent have been discovered. These limitations scale back the probability of generalisability of the outcomes to the worldwide populations. There was no point out of the sampling strategies of the respective research included this evaluation. If a major proportion of the research undertook comfort sampling, this will have biased the outcomes.

This assessment states that the general international prevalence of MMC is extra widespread within the first mandibular molars at 4.4% (95percentCl: 3.5% to five.3%) [about 4 times more common] in contrast with within the second mandibular molars 1.3% (95percentCl: 0.08% to 1.8%). The distinction was statistically and even clinically important. The authors reported that 33 research have been included within the evaluation, nevertheless, 34 research have been listed within the abstract of included research desk and the supplementary desk, and so this quantity was used on this assessment. Regardless of the small percentages, molars ought to at all times be checked for MMC throughout root canal remedy with the intention to keep away from lacking canals and reducing the remedy success price.


Major Paper

Al-Maswary AA, Almadhoon HW, Elkhateb A, Hamdallah A, Halboub E. The World Prevalence of Center Mesial Canal in Mandibular First and Second Molars Assessed by Cone Beam Computed Tomography: A Systematic Evaluation and Meta-Evaluation. J Endod. 2023 Jun;49(6):638-656. doi: 10.1016/j.joen.2023.04.008. Epub 2023 Apr 26. PMID: 37116828.

Evaluation protocol in PROSPERO



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