Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study

BMC Oral Health. 2024 Feb 2;24(1):170. doi: 10.1186/s12903-024-03934-2.

Abstract

Background: Adequate knowledge of root canal morphology and its variation is essential for success of root canal treatment and to overcome treatemnt failure. The aim of this study was to investigate the root and canal morphology of mandibular anterior teeth using 2 classification systems.

Methods: 3342 lower anteriors were evaluated from 557 CBCT scans. The images were examined in sagittal, axial and coronal views using a CS 3D imaging software (V3.10.4, Carestream Dental). Demographic data recorded, the number of roots and canal's morphology were described according to Vertucci and Ahmed classifications.

Results: Frequency of Type I configuration was significantly the highest in incisors and canines (76%, N = 2539), followed by Type III (20.6%, N = 687). Type II (1.1%, N = 37), IV (1.1%, N = 37), and V (0.3%, N = 11) were rarely encountered. 0.9% (N = 31) of the teeth could not be classified with the Vertucci System. The frequency of 2 roots (2MA in Ahmed classification) which has no correspondence in the Vertucci classification, was 1.1% (N = 38), it was significantly higher in canines and in females (35 canines and 3 laterals). A moderate correlation in root canal morpology was found between the left and right sides (V > 0.30). 80% (N = 2538) of the teeth did not exhibit any divergence/merging. The bifurcation level occurred mostly in the middle third of the root.

Conclusions: One fourth of anterior teeth had variation from the simple type I canal configuration and therefore requires attention during treatment. The new classification system offers a more accurate and simplified presentation of canal morphology.

Clinical relevance: The prevalence and mid root bifurcation of second canal in lower anteriors requires attention to ensure adequate quality root canal treatment without compromising the integrity of teeth.

Keywords: Ahmed classification; CBCT; Mandibular anterior teeth; Root canal morphology; Vertucci classification.

MeSH terms

  • Cone-Beam Computed Tomography / methods
  • Dental Pulp Cavity* / anatomy & histology
  • Dental Pulp Cavity* / diagnostic imaging
  • Dentition, Permanent
  • Female
  • Humans
  • Jordan
  • Tooth Root* / anatomy & histology
  • Tooth Root* / diagnostic imaging