Comprehensive Root Canal Curvature Assessment Method (CRCAM): a novel seven-parameter system for predicting endodontic difficulty

Root canal curvature is a critical factor determining endodontic treatment difficulty and success. Existing methods (Schneider, Pruett) assess only single parameters, lacking comprehensive evaluation. To develop and validate CRCAM (Comprehensive Root Canal Curvature Assessment Method), a novel seven-parameter system providing standardized difficulty scoring. CRCAM integrates seven parameters: Schneider angle, Pruett radius, curvature location, canal length, number of curves, severity index, and Path Complexity Score. We validated CRCAM on 1,727 periapical radiographs using automated image analysis. Performance was compared with classical methods and recent computational approaches (2022–2025). CRCAM scores ranged from 23.95 to 96.26 (mean: 73.28 ± 12.26), with five-level difficulty classification: Moderate (2.7%), Difficult (38.0%), Very Difficult (54.0%), and Extremely Difficult (5.4%). Strong correlations were observed between CRCAM and individual parameters (complexity: r = 0.758, angle: r = 0.487, p < 0.001). Compared to Schneider (r = 0.487) and Pruett (r = 0.244) methods alone, CRCAM provided more granular assessment with standardized 0-100 scoring. CRCAM represents the first comprehensive, multi-parameter system for root canal curvature assessment, offering standardized difficulty prediction for clinical decision-making.