Cone-Beam Computed Tomography Assessment of Root Canal Morphological Variations in Maxillary Second Premolars

Background and objective A comprehensive understanding of root canal morphology and its anatomical variations is critical for the success of root canal treatment (RCT). Unrecognized variations may lead to incomplete cleaning, shaping, and obturation, potentially resulting in treatment failure. This study aimed to evaluate the frequency and distribution of root canal configuration types in maxillary second premolars (Mx2P) and their association with gender using cone-beam computed tomography (CBCT). Materials and methods This retrospective cross-sectional study analyzed 384 CBCT scans of fully developed, untreated Mx2Ps in patients aged 18 to 65 years. Teeth with restorations, prior endodontic treatment, gross caries, fractures, ankylosis, or pulpal calcifications were excluded. Root canal morphology was classified according to Vertucci's classification system using the Carestream Dental Imaging Software 3D Module v2.4. Gender-based comparisons were conducted using the chi-square test. Results Scans from 219 patients (114 males (52.1%), 105 females (47.9%)) with a mean age of 42.35 ± 13.79 years were included. The most prevalent canal configuration was Vertucci's Type I (n = 240, 62.5%), followed by Type II (n = 96, 25.0%), Type IV (n = 30, 7.8%), Type VI (n = 3, 0.8%), Type VII (n =3, 0.8%), Type III (n = 7, 1.8%), Type V (n = 4, 1.0%), and Type VIII (n = 1, 0.3%). No statistically significant association was found between root canal morphology and gender (p = 0.915). Conclusion Vertucci's Type I was the most common root canal configuration in maxillary second premolars. The findings highlight the importance of thorough radiographic assessment using CBCT to identify anatomical variations for effective endodontic treatment planning.