Revisiting Premolars Using Cone-Beam Computed Tomography Analysis and Classifying Their Roots and Root Canal Morphology Using Newer Classification

Abstract

Objective: The objective is to compare the internal morphology of premolars while applying the Vertucci and recent classification system for root canal variations in the Gujarat population using CBCT.

Materials and methodology: A sample size of 537 CBCT images collected from various diagnostic centers in Gujarat was analyzed. The root canal morphology was then classified by using two methods - Ahmed et al. and Vertucci classification system. Fisher’s exact test and Chi-square test were used for statistical analysis.

Results: All the premolars revealed a varied canal configuration. More than half of maxillary first and 42% of maxillary second premolars were double rooted. Vertucci type IV classification was the most common in first maxillary premolars and Type I and type IV were commonly seen in second premolars. According to the new system, the code ²N B ¹ P ¹ was commonly seen for first maxillary premolars. The majority of mandibular premolars were single rooted. Classification wise type I Vertucci and ¹ N ¹  were the most common types observed.

Conclusion: Premolars - both maxillary and mandibular - in this subpopulation had a wide range of root canal anatomical variations. Clinicians should be aware of this for a successful treatment outcome. The new system for classifying canal morphology describes the root and canal configurations in a more accurate and practical manner compared to the Vertucci classification and hence can be used routinely.