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Abstract：
OBJECTIVE: 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.
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 1st and 2nd 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 1st molars and 1.2% (95% CI: 0.2-2.83%) for mandibular 2nd molars. The highest prevalence of MMC in 1st 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.
CONCLUSIONS: 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.
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 1st and 2nd 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 1st molars and 1.2% (95% CI: 0.2-2.83%) for mandibular 2nd molars. The highest prevalence of MMC in 1st 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.
CONCLUSIONS: 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.
摘要：
目的：本系统综述和荟萃分析旨在基于锥形束计算机断层扫描（CBCT）研究评估不同人群和地区的下颌恒磨牙中中膜管（MMC）的患病率。
方法：PubMed，Scopus,Embase,WebofScience,和Open-Grey根据特定的关键字进行了搜索，直到2023年10月。对纳入的研究的参考文献和来自三个同行评审的牙髓学期刊的文章进行了手工搜索。感兴趣的主要变量是MMC的患病率。其他数据，如纳入病例总数，人口的年龄和国家，CBCT设备信息,体素大小,并提取了视野细节。提取的数据使用JBI质量评估清单进行定性分析，并使用STATA软件进行定量分析。
结果：在研究的32,793颗牙齿中，下颌第1磨牙和第2磨牙中MMC的累积患病率为3.11%(95%CI:2.00-4.44%).亚组分析显示，下颌第一磨牙的患病率为4.15％（95％CI：2.69-5.89％），下颌第二磨牙的患病率为1.2％（95％CI：0.2-2.83％）。第一磨牙中MMC的患病率最高的是南亚（11.24％）和非洲（6.61％）。
结论：MMC的患病率因地区而异。临床医生应该意识到MMC的潜在流行，特别是在下颌第一磨牙中，因为错过MMC可能导致牙髓失败。
结论：MMC的存在在不同的地理区域有所不同（0％至29.7％）。临床医生在对下颌磨牙进行牙髓治疗时应始终寻找MMC，因为这条运河的存在并不少见。我们建议寻找该管，就像寻找上颌第一磨牙的第二个近颊管一样。
方法：PubMed，Scopus,Embase,WebofScience,和Open-Grey根据特定的关键字进行了搜索，直到2023年10月。对纳入的研究的参考文献和来自三个同行评审的牙髓学期刊的文章进行了手工搜索。感兴趣的主要变量是MMC的患病率。其他数据，如纳入病例总数，人口的年龄和国家，CBCT设备信息,体素大小,并提取了视野细节。提取的数据使用JBI质量评估清单进行定性分析，并使用STATA软件进行定量分析。
结果：在研究的32,793颗牙齿中，下颌第1磨牙和第2磨牙中MMC的累积患病率为3.11%(95%CI:2.00-4.44%).亚组分析显示，下颌第一磨牙的患病率为4.15％（95％CI：2.69-5.89％），下颌第二磨牙的患病率为1.2％（95％CI：0.2-2.83％）。第一磨牙中MMC的患病率最高的是南亚（11.24％）和非洲（6.61％）。
结论：MMC的患病率因地区而异。临床医生应该意识到MMC的潜在流行，特别是在下颌第一磨牙中，因为错过MMC可能导致牙髓失败。
结论：MMC的存在在不同的地理区域有所不同（0％至29.7％）。临床医生在对下颌磨牙进行牙髓治疗时应始终寻找MMC，因为这条运河的存在并不少见。我们建议寻找该管，就像寻找上颌第一磨牙的第二个近颊管一样。
