Application of the Ahmed et al. classification system to permanent anterior root and canal anatomy in a Namibian population: A cone-beam computed tomography study

Abstract

Knowledge of population-specific root canal anatomy is critical to successful root canal treatment and to reducing the risk of missed canals; however, cone-beam computed tomography (CBCT)-based data for the permanent anterior dentition of the Namibian population are lacking. Therefore, this study evaluated the root and canal morphology of permanent anterior teeth in a Namibian population using CBCT and classified configurations according to the Ahmed et al . classification system. In this descriptive, retrospective cross-sectional study, CBCT scans obtained from three private dental clinics in Swakopmund and Windhoek, Namibia (2018–2025), were analyzed. Permanent maxillary and mandibular anterior teeth were evaluated for root number and canal configuration and classified using the Ahmed et al . classification system. The prevalence was summarized using frequencies and percentages, and associations with sex, age group, tooth type, and side were assessed using Chi-squared or Fisher’s exact tests (α = 0.05). Overall, 3120 anterior teeth from 260 individuals were evaluated. Almost all teeth were single-rooted (99.97%). Maxillary anterior teeth predominantly exhibited a single-canal configuration ( 1 MXA 1 ), whereas mandibular incisors demonstrated a higher prevalence of complex configurations, particularly 1 MDA 1-2-1 . Complex configurations were more common in males overall, and maxillary canal complexity increased with age. Although most anterior teeth displayed simple internal anatomy, complex configurations were most common in mandibular incisors, were more prevalent in males overall, and increased with age in the maxilla. The Ahmed et al . classification system provided a comprehensive framework for reporting both simple and complex root and canal morphology