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Related Concept Videos

Teeth01:15

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Maxillary First Premolars' Internal Morphology: A Systematic Review and Meta-Analysis.

Thomas Gerhard Wolf1,2, Dilara Sare Ulugöl1, Richard Johannes Wierichs3

  • 1Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland.

Dentistry Journal
|November 26, 2025
PubMed
Summary
This summary is machine-generated.

This review found maxillary first premolars (Mx1Ps) most commonly have two roots and a 2-2-2/2 root canal configuration (RCC). Sex-specific differences in Mx1P morphology were identified, impacting endodontic treatment planning.

Keywords:
internal morphologymaxillary first premolarsmeta-analysisroot canal configurationsex differencessystematic review

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Area of Science:

  • Endodontics
  • Dental Anatomy
  • Anthropology

Background:

  • Understanding root canal morphology and configuration (RCC) is crucial for successful endodontic treatment.
  • Maxillary first premolars (Mx1Ps) exhibit significant anatomical variations.
  • Limited data exists on sex-specific differences in Mx1P RCC.

Purpose of the Study:

  • To systematically review and analyze the root canal morphology and configuration (RCC) of maxillary first premolars (Mx1Ps).
  • To investigate sex-specific differences in Mx1P RCC based on existing literature.

Main Methods:

  • Systematic literature search conducted in five databases (Cochrane, Embase, LILACS, Scopus, MEDLINE via PubMed).
  • PRISMA guidelines and AQUA tool were used for study selection and quality assessment.
  • Data extraction focused on RCC prevalence, sex differences, root variations, and examination methods.

Main Results:

  • 86 studies analyzing 31,325 teeth were included. The most common RCCs were 2-2-2/2 (IV) and 1-1-1/1 (I).
  • Mx1Ps predominantly had two roots (7.1-96.2%) or one root (3.8-93.2%); three-rooted variants were rare (0.4-6.5%).
  • Males showed higher frequencies of two- or three-rooted Mx1Ps with specific RCCs (e.g., 2-2-2/2, 1-1-3/3), while females had higher frequencies of others (e.g., 1-1-1/1, 2-2-1/1).

Conclusions:

  • Maxillary first premolars predominantly feature two roots and a 2-2-2/2 (IV) root canal configuration.
  • Cone-beam computed tomography (CBCT) was the most prevalent examination method.
  • Clinicians must consider sex-specific and morphological variations in Mx1Ps for effective endodontic therapy.