Evaluation of the root and canal morphology of maxillary and mandibular premolars in an Emirati subpopulation using cone beam computed tomographic data: A retrospective study

Abstract

Background: Missed canal anatomy is one of the most common cause of endodontic therapy failure. Numerous studies have reported that maxillary and mandibular premolars have a complex internal canal configuration, which can vary according to race and geographic origin. Therefore, a thorough knowledge and understanding of the root and canal morphology is crucial, to ensure successful outcome of root canal treatment.

Aim: To describe the root and canal morphology of Maxillary and Mandibular first and second premolars in Emirati subpopulation by analyzing the 3-dimentional data from Cone-beam Computed Tomographic (CBCT) images.

Materials and Methods: This is a retrospective study, in which 360 CBCT scans of patients treated at Healthpoint Dental center (Mubadala, Abu Dhabi), United Arab Emirates, between 2017-2018, were obtained and analyzed. The institutional review board approval was obtained to collect and analyze the CBCT scans for the purpose of this study. All CBCT scans at HDC were acquired using Orthophos SL (Dentsply Sirona, USA) by the same technician using the following imaging protocol; 85 Kv, 7 mAs, with exposure time of 5 seconds and voxel size of 0.15 mm. Two evaluators reviewed and recorded the findings twice with an intersession of 30 days. They recorded the number and shape of roots and categorize the canal morphology based on Vertucci classification (VC).

Results: Most of maxillary first premolars had 1 root (52.1%), while only 0.9% had 3 roots. Type I VC was the most common canal configuration (53.8%). The majority of maxillary second premolars had 1 root (91%). Type I was the most canal configuration (47.4%), followed by Type III (32.4%). Most of mandibular first and second premolars had 1 root (77.3% and 97%, respectively) and Type I was the most common canal configuration (70.4% and 94.9%, respectively). C-shape canals were markedly noticed in mandibular first premolars with prevalence of 22.7%.

Conclusion: This is the first study to investigate the root and canal morphology of maxillary and mandibular premolars in an Emirati subpopulation using CBCT. Our data showed great variations in the root and canal morphology of maxillary and mandibular premolars in Emirati populations. The prevalence of C-shaped canal in mandibular premolars in Emirati population is considered relatively high (22.7%) in comparison to other populations.