Root and canal configurations of maxillary first premolars in 22 countries using two classification systems: a multinational cross-sectional study
This study aimed to evaluate the root and root canal morphology of maxillary first premolars (M1Ps) globally using cone-beam computed tomography (CBCT), comparing results with Vertucci's and Ahmed et al.'s classification systems. CBCT images were obtained for various purposes such as orthodontic treatment planning, tooth impaction, implant surgery, and trauma cases. M1Ps were evaluated in three planes to determine root and root canal morphology, and root bifurcation levels were assessed using integrated software. Prevalence variations between countries and overall prevalence were analyzed using meta-analysis software. A total of 6,600 patients (13,200 bilateral M1Ps) were examined. According to Vertucci's classification, Type IV (59%), Type II (12%), Type I (9%), and Type III (8%) were the most common configurations. Based on Ahmed's classification,<sup>2</sup>MP B<sup>1</sup> P<sup>1</sup> was the most prevalent configuration (53%), followed by <sup>1</sup>MP<sup>1</sup> (9%),<sup>1</sup>MP<sup>1-2-1</sup> (8%), and <sup>1</sup>MP<sup>2-1-1</sup> (7%). The prevalence of <sup>2</sup>MP B<sup>1</sup> P<sup>1</sup> by gender revealed a pooled prevalence of 58% in males and 50% in females. No significant difference was found across age ranges (p > 0.05). Ahmed's classification system provided a more comprehensive analysis by successfully classifying all cases, whereas Vertucci's system failed to categorize 1.8-2.7% of the cases. Significant bilateral symmetry in root morphology was noted. There are regional and gender-specific differences in the root canal morphology of M1Ps. Ahmed et al.'s classification system was more comprehensive, effectively categorizing all observed morphologies compared to Vertucci's system, which had limitations and left some morphologies unclassified.
Authors
- Ahmad A. Madarati (ORCID: https://orcid.org/0000-0001-8645-3024)
- Rohan Jagtap (ORCID: https://orcid.org/0000-0002-9115-7235)
- Anna Lehmann (ORCID: https://orcid.org/0000-0002-8951-4045)
- Ömer Hatipoğlu (ORCID: https://orcid.org/0000-0002-4628-8551)
- David Donnermeyer (ORCID: https://orcid.org/0000-0001-7162-9795)
- Suha Alfirjani
- Glynn Dale Buchanan (ORCID: https://orcid.org/0000-0003-2957-166X)
- Benjamín Martín‐Biedma (ORCID: https://orcid.org/0000-0002-4297-4220)
- M. Rahimi (ORCID: https://orcid.org/0000-0003-0856-4559)
- Anja Ivica
- Mohmed Isaqali Karobari (ORCID: https://orcid.org/0000-0002-0313-9695)
- Güldane Mağat (ORCID: https://orcid.org/0000-0003-4418-174X)
- Fatma Pertek Hatipoğlu (ORCID: https://orcid.org/0000-0003-0307-3021)
- Xenos Petridis (ORCID: https://orcid.org/0000-0002-3449-231X)
- Ahmed A. Madfa (ORCID: https://orcid.org/0000-0001-6124-0129)
- Nessrin A. Taha (ORCID: https://orcid.org/0000-0003-3233-8850)
- Paulo Palma (ORCID: https://orcid.org/0000-0003-4730-8072)
- Wen Yi Lim (ORCID: https://orcid.org/0000-0002-9926-7922)
- Nisrein Makahleh
- Safaa Allawi (ORCID: https://orcid.org/0000-0002-5436-5297)
- Indira Tulegenova (ORCID: https://orcid.org/0000-0002-4342-2372)
- Martha Gallegos Intriago
- Rafael Fernández‐Grisales (ORCID: https://orcid.org/0000-0002-1431-8373)
- Abdelrahman M. Hamouda (ORCID: https://orcid.org/0009-0007-3609-7229)
- O.E. Bekjanova (ORCID: https://orcid.org/0000-0002-1686-1820)
- Tanvi Shah
Institutions
- University of Aleppo (SY)
- University of Technology Sydney (AU)
- University of Bern (CH)
- Poznan University of Medical Sciences (PL)
- The University of Sydney (AU)
- Central University of Ecuador (EC)
- University of Auckland (NZ)
- Jordan University of Science and Technology (JO)
- Recep Tayyip Erdoğan University (TR)
- University of Zagreb (HR)
- Al-Azhar University (EG)
- Kazakh National Medical University (KZ)
- Universidade de Santiago de Compostela (ES)
- National and Kapodistrian University of Athens (GR)
- University of Münster (DE)
- Sydney Dental Hospital (AU)
- University of Mississippi Medical Center (US)
- University of Benghazi (LY)
- University of Ha'il (SA)
- Riyadh Elm University (SA)
- Necmettin Erbakan University (TR)
- National Dental Centre of Singapore (SG)
- Instituto de Investigación Sanitaria de Santiago (ES)
- Clínica CES (CO)
- University of Pretoria (ZA)
- University of Coimbra (PT)
- Saveetha University (IN)
- Damascus University (SY)
Publication Details
- Journal
- Scientific Reports
- Published
- 2025-06-02
- DOI
- https://doi.org/10.1038/s41598-025-02669-6
- Citations
- 1
- Primary Topic
- Endodontics and Root Canal Treatments
- Type
- article
- Field-Weighted Citation Impact
- 1.79