Evaluation of root canal morphology in permanent maxillary and mandibular anterior teeth in Saudi subpopulation using two classification systems: a CBCT study

Abstract

Background Adequate knowledge of root canal morphology and possible variations is essential to achieve perfect root canal treatment and overcome treatment failure. Appropriate knowledge on root and canal morphology, communication, and documentation amongst dentists will be challenging from a diagnostic and successful treatment point of view. Methods A total of 3420 samples were included in this study from 285 cone-beam computed tomography images of the Saudi residents, including 171 males and 114 females aged 15 to 68 years from retrospective data dated from January 2018 to April 2021. The images were examined in sagittal, axial and coronal views using a 3D version software 1.0.10.6388. The number of canal and canal morphology was recorded using Vertucci and the new classification system. The SPSS 26 was used to conduct the statistical analysis as descriptive statistics such as mean; standard deviation and frequency were calculated. The Chi-square test analysed the data with the significance level set at 0.05. Results A total of 285 subjects participated in the study. Majority of the participants were Saudi nationals (80.7%), followed by Indian (7.4%), Pakistani (4.2%) and other nationalities. According to Vertucci and the new classification system, Type I and 1TN1 were the most common types, followed by Type III and Type IV, and then 1TN1-2-1 and 1TN1-2 in mandibular anteriors. The prevalence of canal variations in mandibular canine was higher in females than in males (P = 0.002). Maxillary laterals and mandibular anteriors showed the significant difference in the prevalence of root canal variation in relation to the ethnicity (P = 0.001) and age of the patients. Younger patients showed more variations than the older patients (P = 0.012, P = 0.023, P = 0.001, P = 0.001) in terms of maxillary laterals, mandibular central, laterals and canines, respectively. Conclusion Mandibular permanent anteriors showed a wide range of canal variations and canal complexity. Males and females did not demonstrate a wide range of variation in the root canal morphology except for the canines in relation to the gender of the patients.

Root Morphology and Canal Configuration of Permanent Canines Among Saudi Population: Systematic Review and Comparison with Worldwide Studies

“…41,49,50 Conversely, few local original studies have investigated canine morphology. 2,3,[29][30][31][32][33] Maxillary canines usually have one root and one canal and rarely have two roots or two channels. This condition explains local or/and international case reports involving maxillary canines with double roots or canals are few.…”

“…43,[45][46][47][48] Other studies reported mandibular canines with two canals and two roots. 41,42,44,49,50 Among the Saudi population, quite a few number of peer-reviewed original studies and research 2,3,[29][30][31][32][33] or case reports [41][42][43][44][45][46][47][48][49][50] have investigated the RMCC of permanent canine as shown in Table 1. Most other original research studies that investigated the canine has been conducted outside the Saudi population [20][21][22][23][24][25][26][52][53][54][55][56][57][58][59][60] as presented in Table 2.…”

Roots and Root Canals Characterization of Permanent Mandibular Premolars Analyzed Using the Cone Beam and Micro Computed Tomography—A Systematic Review and Metanalysis

“…Various techniques to analyze the structure of the root canal include tooth clearing technique, tooth sectioning, conventional radiography, CBCT, and micro-computed tomography (micro CT) [ 10 ]. However, tooth clearing and sectioning can be useful for in-vitro studies, and they are not typically performed in a clinical setting.…”

Application of two systems to classify the root and canal morphology in the human dentition: A national survey in India

“…5 In 2017, Ahmed et al 6 introduced a coding system to overcome shortcomings of previous classifications, such as inaccurate characterization of the root and inability to classify complex root canal anatomy, which has been evidenced in several laboratory and clinical studies. [5][6][7][8][9][10][11] This system includes codes for the number of teeth, the number of roots, and the different types of root canal morphology. This classification system for root and canal morphology has been implemented in both clinical and academic research settings 12,13 (Figure 1).…”