Cone-beam computed tomography evaluation of the relationship between mandibular posterior root apices and the mandibular canal in the eastern province of Saudi subpopulation

Abstract Introduction: The current study investigated the anatomical relationship between the root apices of mandibular posterior teeth and the mandibular canal, assessing the impact of gender and age on these parameters through cone-beam computed tomography (CBCT) in an Eastern Saudi Arabian subpopulation. Materials and Methods: In the current retrospective study, 102 CBCT scans of Saudi patients (57 females and 45 males; aged 20–60 years) with intact mandibular posterior teeth were analyzed. Scans were obtained using a NewTom scanner and analyzed in multiplanar reconstruction views. The distance between the root apex and the mandibular canal was assessed for both the first and second molars, as well as the premolars. Two endodontists and one oral radiologist performed measurements, demonstrating excellent intra- and interexaminer reliability (intraclass correlation coefficient = 0.95). Independent t -test and Pearson’s correlation were used for gender and age comparisons. The level of significance ( P value) was set at 0.05. Results: Males showed greater mean root apex-to-mandibular canal distances for all teeth, especially in premolars. Significant gender difference was observed at the left second molar (Left mandibular second molar [LL7]; P = 0.043), with borderline significance at the left first premolar (Left mandibular first premolar [LL4]; P = 0.050). Patient age did not significantly correlate with root-to-canal distance. Conclusion: The study identified gender-based differences in the proximity of mandibular posterior tooth roots to the mandibular canal, with females exhibiting shorter root-to-canal distances at the left second molar and first premolar. In addition, the distance to the mandibular canal was not significantly correlated with age.