Three-dimensional assessment of root canal morphology in Iraqi permanent maxillary first and second premolars using cone beam computed tomography (retrospective study)
TL;DR
With particular reference to the little likelihood of presenting more than two roots and canals in the U4 and more intricate canalicular anatomy in the middle third of this root, clinicians should be mindful of the tooth’s diversified anatomical complexity.
Abstract
INTRODUCTION. The optimum root canal treatment outcome is usually governed by excellent instrumentation and shaping of the endodontic system, debridement and ultimate disinfection protocol. Therefore, it is extremely necessary to investigate the complicated morphology of the endodontic system with a reliable and accurate methodology.
Materials And Methods
Three hundred and eighty-four CBCT images (620 total number of teeth) of Iraqi people aged 15–45 years old and obtained between 2019–2024 were collected. CBCT scans of maxillary premolars (U4 and U5) were examined in three different planes (axial, coronal, and sagittal) to identify root number, root canal number and its configuration (according to Vertucci classification) and, tooth anomalies including. These findings were correlated with gender. Pearson chi-square (χ 2 ) test was used for data comparison at confidence interval (95%), and margin of error (0.05).
Results
Seventy percent of the examined U4 had 2 roots, while triple and single-rooted represented 1% and 29% of overall samples, respectively. Seventy-nine percent of the examined U5 had 1 root, while triple and double-rooted represented 0% and 21%, respectively. The predominant canal number in the U4 was two (71%), followed by single and triple canals in 27% and 1% respectively with predominant type V configuration. For U5, 70% comes with single canal and 29% with double canals with type I predominant configuration. Majority of these parameters showed statistical relations with tooth and gender.
Conclusion
This study used CBCT to identify internal canal anatomy in a sample of permanent maxillary premolars drawn from an Iraqi population, with variations in prevalence related to gender and tooth. With particular reference to the little likelihood of presenting more than two roots and canals in the U4 and more intricate canalicular anatomy in the middle third of this root, clinicians should be mindful of the tooth’s diversified anatomical complexity. This could help dentists perform endodontic procedures and hence impact the result. However, there is not enough data to suggest that this tooth be scanned in three dimensions prior to endodontic treatment.