Population-Specific Anatomical Variations in Premolar Root Canal Systems: A Cross-Sectional Cone-Beam Computed...

Background/Objectives: The morphology of roots and root canals has a significant influence on the outcome of endodontic treatment. This study aimed to compare premolar root and root canal configurations between Central American and European subpopulations using cone-beam computed tomography (CBCT). Methods: This cross-sectional retrospective study analyzed CBCT scans of 2919 premolars from 561 patients: 197 from Jamaica (Central America) and 364 from Portugal (Europe). The analysis focused on the number of roots, root canal configurations, and the presence of C-shaped canals in mandibular premolars. Demographic factors such as age and sex were also considered. Statistical significance was determined using chi-square tests with a significance level set at p < 0.05. Results: Overall, premolars in Jamaican patients had more roots and root canals compared to those in Portuguese patients. Three-rooted configurations were more common in Jamaica, particularly in maxillary first premolars (5.5% vs. 2.9%, p < 0.05). Vertucci Type V configuration was more prevalent in the Central American subgroup, while Portuguese premolars were more likely to exhibit Types II and IV configurations. C-shaped canals were rare in both populations (p > 0.05). Males and younger patients showed higher frequencies of multi-root and multi-canal configurations (p < 0.05). Conclusions: This study reveals significant geographic and demographic differences in premolar root and root canal morphology between two Central American and European subpopulations. Premolars from Jamaica tend to exhibit more complex anatomical features compared to those from Portugal. These findings highlight the need for population-specific diagnostic and treatment strategies and demonstrate the value of CBCT in the preoperative diagnosis of complex anatomical variations.