Association of Mandibular Posterior Anatomic Limit with Skeletal Patterns and Root Morphology Using Three-Dimensional Cone Beam Computed Tomography Comprehensive Analysis

This study aimed to clarify the relationship between the mandibular posterior anatomic limit (MPAL) and skeletal anteroposterior and vertical skeletal patterns, with consideration of factors that may be related. In total, 230 people were included: 49 Japanese, 122 Egyptian, and 59 Korean people. The MPAL was measured at 0, 2, 4, and 6 mm from the root furcation along the sagittal and cuspal lines at the distance from the distal root of the mandibular right second molar to the mandibular cortex of the lingual bone. Eight different MPALs were evaluated using multiple regression analysis with explanatory variables for anteroposterior and vertical skeletal patterns and qualitative variables for age, sex, population, the presence of third molars, number of roots, presence of C-shaped roots, and Angle malocclusion classification. The MPAL was significantly larger as the mandibular plane angle decreased. The MPAL near the root apex was significantly larger as the A-nasion-point B angle increased, and the MPAL near the root apex measured at the cuspal line was significantly larger for C-type roots. The present study showed that a C-shaped root affected the MPAL in addition to the anteroposterior and vertical skeletal patterns.