Volumetric pulp chambers measurements in mandibular and maxillary permanent first molar using cone-beam computed tomography BY age and gender

Aim: Today, cone beam computed tomography (CBCT) has become a valuable tool for the practice of dentistry. There is a wide range of applications in diagnosis, the treatment planning, treatment and after the treatment process. The aim of this study was to demostrate the anatomical structure of pulp chamber, measure the volume of the total pulp chambers in mm3 and evaluate the pulp chamber volume changes by age and gender statistically in mandibular and maxillary first molars by means of CBCT. Material and Methods: In our thesis study, CBCT examinations of patients between the ages of 7-18 years, which were carried out due to different reasons and stored in the archive of Dental and Maxillofacial Radiology Department of the Faculty of Dentistry of Dicle University were evaluated retrospectively. The CBCT images of a total of 160 patients were investigated and 80 patients, who did not have any dental caries, restoration, root canal treatment and veneer crown, taurodont anomaly, any tooth extraction or pathological process in the surrounding tissues were randomized into four groups according to age, if they had lower and upper right permanent first molar teeth visualized in their CBCT. Each group in itself was divided into two subgroups according to the gender of the patients. With the help of the categorized CBCT images, the total pulp chamber of the lower and upper right permanent first molar teeth were segmented with the 3D Slicer software program. Then they were reconstructed and the volumes of the total pulp chamber were measured in mm3. We analyzed the collected data with statistical analysis methods and we evaluated whether there was any difference between the patients grouped according to the age and gender in respect of volume changes in the total pulp chamber of the lower and upper permanent first molar teeth and whether there was any difference between the mean volume values and gender of the patients within the same group. Kolmogorov-Smirnov test was used to determine whether the data was normally distributed and the homogeneity of the data was tested with Levene tests. For the comparison of the mean values of the groups one-way analysis of variance (ANOVA) test, for the multiple comparison between the groups Tukey-HSD test and for the independent groups Independent-t test were implemented. The confidence interval was 95% for all statistical tests and the accepted limit of significance was p<0.05. Results: Comparison of the volume measurements of the lower and upper first permanent molar teeth between the groups showed that the volume values of the total pulp chamber decreased depending on the age (p<0.05). Regarding gender, volume decrease related to age was statistically more significant among females. We determined in all age groups except age 7-9 group that the volume value of the total pulp chamber of the upper permanent first molar teeth was higher than the volume value of the total pulp chamber of the lower permanent first molar teeth. Mean volumes of the total pulp chamber of the lower and upper first molar teeth between the males and females within the same group were also compared. This comparison showed that there was a statistically significant difference for both lower and upper permanent first molar teeth in Group 3 and only for upper permanent first molar teeth in Group 4. Conclusions: A detailed examination of the pulp chamber anatomy and the changes in its dimensions is widely important determine the deposition of secondary dentin with age. We believe that CBCT is an easy and conservative method for the 3D-imaging of the pulp chamber, volume measurement and examination of the dimensional changes of the total pulp chamber depending on age. We also believe that further studies with a larger patient sample are needed for the evaluation of the volume changes of the pulp chamber in the lower and upper first molar teeth in the individuals between the ages of 7-18 years and for the evaluation of the pulp chamber dimensions in respect of sexual dimorphism. Keywords: Volumetric measurement, cone-beam computed tomography, total pulp chamber