Anatomical Variability of Mandibular Root Canal Systems in a Saudi Clinical Sample: A CBCT Study Using Ahmed and Vertucci Classifications

Understanding anatomical variations in root and canal morphology is essential for successful endodontic treatment. Studies based on clinical populations provide valuable data for clinicians treating patients with similar demographic and anatomical characteristics. This study evaluated root and canal morphology of mandibular teeth in a Saudi clinical sample using cone beam computed tomography (CBCT).

This retrospective cross-sectional study analyzed CBCT scans of 150 patients from Hail Dental Center, Saudi Arabia. A total of 1104 mandibular teeth (with the individual tooth serving as the unit of analysis) were evaluated using a Carestream CS 8100 3D system (0.15 mm voxel size). Three calibrated endodontists independently assessed root number, canal configurations using Vertucci and Ahmed classification systems, and C-shaped canals using Fan's classification.

Single-rooted teeth comprised 83.2% (n = 918) of the sample, while two-rooted teeth accounted for 16.6% (n = 183). The Ahmed-Dummer classification revealed single canal configuration (¹) in 61.2% (n = 676), followed by ¹²¹ (13.0%), M¹D¹ (8.2%), and ¹² (7.9%). C-shaped canals were identified in 2.2% (n = 24) of teeth, with highest prevalence in first premolars (7.2%), second molars (6.4%), and second premolars (3.3%).

This study provides comprehensive data on mandibular tooth morphology in a Saudi clinical sample. Significant anatomical variations, particularly in premolars and molars, emphasize the importance of preoperative CBCT assessment. The Ahmed-Dummer classification proved valuable for documenting complex anatomical variations beyond traditional classification systems.