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Background: Understanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation. Method: This cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761–70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05. Results: The distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females. Conclusion: This study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars. [ABSTRACT FROM AUTHOR]

Background: In complex teeth like maxillary premolars, endodontic treatment success depends on a complete comprehension of root canal anatomy. The research on mandibular premolars' root canal anatomy has been extensive and well-documented in existing literature. However, there appears to be a notable gap in available data concerning the root canal anatomy of maxillary premolars. This study aimed to explore the root canal morphology of maxillary premolars using cone-beam computed tomography (CBCT) imaging, considering age and gender variations. Methods: From 500 patient CBCT scans, 787 maxillary premolar teeth were evaluated. The sample was divided by gender and age (10–20, 21–30, 31–40, 41–50, 51–60, and 61 years and older). Ahmed et al. classification system was used to record root canal morphology. Results: The most frequent classifications for right maxillary 1st premolars were 2MPM1 B1 L1 (39.03%) and 1MPM1 (2.81%), while the most frequent classifications for right maxillary 2nd premolars were 2MPM1 B1 L1 (39.08%) and 1MPM1 (17.85%). Most of the premolars typically had two roots (left maxillary first premolars: 81.5%, left maxillary second premolars: 82.7%, right maxillary first premolars: 74.4%, right maxillary second premolars: 75.7%). Left and right maxillary 1st premolars for classes 1MPM1 and 1MPM1–2−1 showed significant gender differences. For classifications 1MPM1 and 1MPM1–2−1, age-related changes were seen in the left and right maxillary first premolars. Conclusion: This study provides novel insights into the root canal anatomy of maxillary premolars within the Saudi population, addressing a notable gap in the literature specific to this demographic. Through CBCT imaging and analysis of large sample sizes, the complex and diverse nature of root canal morphology in these teeth among Saudi individuals is elucidated. The findings underscore the importance of CBCT imaging in precise treatment planning and decision-making tailored to the Saudi population. Consideration of age and gender-related variations further enhances understanding and aids in personalized endodontic interventions within this demographic. [ABSTRACT FROM AUTHOR]

This current paper aims to review the literature on the root canal configuration (RCC) and root structure of permanent mandibular premolars. To find the published scientific literature on the RCC of mandibular premolars up to July 2022, a systematic search of four electronic databases was performed. The studies were selected, rendering to a predetermined point of reference: "mandibular 2nd premolar", "root and canal system", "morphology of root and canal", "root and canal configuration", and "morphology", along with "anatomy" and "mandibular premolars". Cross-referencing along with screening through the bibliographies of the chosen articles resulted in the identification of further studies. In the current study, we examined 30 different articles, and we chose them based on the quality of research investigations. From 3471 retrieved studies, a total of 15981 mandibular 2nd premolars were observed in 30 studies. The mean JBI score for studies assessing the structure of the root, as well as the root canal of the mandibular 2nd premolar, was 7.78 ± 0.81. We have found a pooled prevalence of 91.82% for Vertucci class I root canal morphology and 78.63% pooled prevalence of single-rooted mandibular second premolar. A total of 8677 mandibular 1st premolars were observed in 22 studies. The mean JBI score for studies assessing the structure and anatomy of the root, as well as root canal of mandibular 1st premolar, was 7. 95 ± 0.85. We have found a pooled prevalence of 74.34% for Vertucci class I root canal morphology and 85.20% pooled prevalence of single-rooted mandibular 1st premolar. Mandibular first and second premolars were mostly single-rooted teeth (89.5–100%). The most frequently seen RCC is a 1-1-2-/2 (type V–Vertucci's), followed by 1-1-2-/1 (type IV– Vertucci's; type III–Weine's), and finally RCC 2-2-2-1 (type IV–Vertucci's; type III–Weine's). Presently, the imaging of CBCT is the most used research approach for studying Mn2Ps' structural characteristics. [ABSTRACT FROM AUTHOR]

This systematic review's objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci's classification system (n-16) and the four-digit system (n-6). [ABSTRACT FROM AUTHOR]

This cone beam computed tomography (CBCT) study aimed to evaluate the root canal morphology of permanent anteriors in Malaysian population using two classification systems (Vertucci 1984 and Ahmed et al 2017). CBCT images of 856 patients with 10,080 anterior teeth were analysed. Results showed that, except for six mandibular canines, all anterior teeth were single‐rooted. According to Ahmed et al's system and Vertucci's classification, code 1MaxA1 and type I were the most common types except in mandibular laterals where 1ManA1‐2‐1 and type III were the most common, respectively. The prevalence of canal variations in mandibular incisors was higher in males and the 20–30 age group than in females and other age groups (P < 0.001). The Malay ethnic group showed more canal variations in mandibular incisors than Chinese and Indians (P < 0.001). Mandibular anteriors showed a wide range of canal variations, and the canal complexity is significantly affected by sex, ethnicity and age. The new classification provides an accurate presentation for root canal morphology. [ABSTRACT FROM AUTHOR]

Introduction. While there are many root morphology classification systems with their own distinct advantages, there are many shortcomings that come along with each system. Objectives. The aim of this review was to compare the various root and root canal morphology classifications, their advantages, limitations, and clinical and research implications. Data Sources and Selection. An extensive literature search was conducted on PubMed and Scopus to identify the published data on root and root canal classification systems published until 1 May 2020 using keywords, root canal classification system, classification systems for root canals, and root morphology. The related literature was reviewed and then summarized. Data Synthesis. Several studies have analysed and detailed root and root canal classifications and further added new subsystems, works of Weine et al. (1969) and Vertucci et al. (1974). Besides, Sert and Bayirli (2004) added supplementary types to Vertucci's classification system. A new classification was most recently introduced by Ahmed et al. (2017) involving the use of codes for tooth numbering, number of roots, and canal configuration. Conclusions. Weine et al. classified only single-rooted teeth, without considering multirooted teeth and complex configurations. Vertucci's classification included complex configurations, with Sert and Bayirli adding further complex supplemental types. Ahmed et al.'s classification simplifies classifying root and canal morphology while overcoming the limitations of several previous classification systems making it beneficial for implementation in dental schools. [ABSTRACT FROM AUTHOR]