Assessing The Prevalence of Anatomical Variations in Root Canals of Maxillary Molars and Premolars Using Cone Beam Computed Tomography in Erbil City: Retrospective CBCT Study

Background and objective: Root canal variations can be a challenge to detect and manage when performing root canal therapy, and failure to detect these variations in the root canals of the teeth will lead to unsatisfactory results of the treatment. An important tool for observing the root canal anatomy of teeth that are indicated for root canal treatment is cone beam computed tomography (CBCT). The objective of this study is to find out the rate of anatomical variations in the root canals of maxillary premolars and molars using CBCT among a Kurdish subpopulation in Erbil, Iraq. Materials and method: Data were collected from five dental clinics and radiographic centers in Erbil City. A total of about 690 CBCT images were used for the study, after applying the exclusion criteria, 205 CBCT images were included for the study. maxillary premolars and molars were examined for the number of roots, number of canals, and presence of root canal variations. Results: The prevalence of the second mesiobuccal (MB2) canal in maxillary first molars (MFM) was 47.8%, while in maxillary second molars (MSM), it was 18.05%. The prevalence of the second distobuccal (DB2) canal in (MFM) was 1.46%, with three recorded cases, while none of the (MSM) had a (DB2) canal. Additionally, only 2 cases (0.98%) in MSM had two palatal canals, whereas no such cases were recorded in MFM. A single case of MFM (0.49%) was recorded with two roots and canals, whereas in (MSM), 10 cases (4.88%) had two canals. In maxillary first premolars, five cases (2.44%) were reported with three roots and canals (molarized premolars). Similarly, five cases (2.44%) had a single canal, while 195 cases (95.12%) had two canals: one buccal and one palatal. In maxillary second premolars, 135 cases (65.85%) had two canals (buccal and palatal), and 70 cases (34.15%) had a single canal. Conclusion: There is a wide range of variations among maxillary molars and premolars, which need careful diagnostic evaluation to prevent missing canals during root canal treatment. Keywords: Anatomical variations, second mesiobuccal canal (MB2), Second distobuccal canal (DB2), Three rooted premolars (Molarized premolars), Second palatal canal (P2), Cone Beam Computed Tomography (CBCT), Erbil city