CBCT based three dimensional odontometric mapping of maxillary anterior teeth in an Indian cohort to guide precision endodontic access cavity preparation

Access cavity preparation is an important part of endodontic therapy, affecting the effectiveness of canal instrumentation and the durability of the tooth over time. Currently, most access preparation protocols are based on information from a Western population and do not address the anatomical differences of different ethnic groups. This retrospective CBCT study assessed specific odontometric measurements in maxillary anterior teeth-central incisors, lateral incisors and canines-using an Indian population to help identify a clinically relevant and conservative access cavity preparation. A total of six hundred cone-beam computed tomography (CBCT) images of maxillary central incisors, lateral incisors, and canines (n = 200 per tooth) were evaluated. Three measurements were made in sagittal view: the distance from the central fossa to the pulp chamber roof (CF-PC), the incisal edge to pulp chamber (IE-PC), and the central fossa to cingulum (CF-C). These images were obtained from Indian individuals aged 18 to 25 years. Differences attributable to sex-based variation, and between teeth, were statistically significant (p < 0.05). The lateral incisors had the largest amount of anatomical variability, while the canines had the steepest trajectory of access. These findings provide the first population-based CBCT base-line morphometric values for maxillary anterior teeth in India, and a practical guide to help achieve safe access design that is mindful of tooth anatomy and minimizes the invasiveness of the access.