Root Canal Morphology of Mandibular Premolars in a Nepalese Population: A Cone-Beam Computed Tomographic Study.

Abstract

Background Mandibular premolars are the most challenging teeth to treat endodontically because of their variability in morphological and internal anatomical features. The knowledge of root canal morphology and its variation is crucial for the endodontic success. Objective To evaluate the root and canal morphology of mandibular premolars in a Nepalese population by using Cone Beam Computed Tomography. Method A total of 1924 mandibular first and second premolar teeth from 481 patients were evaluated. The number of roots and canal configuration were identified and categorized according to Vertucci's classification. An association between number of roots and root canal configuration with gender and ethnic group was evaluated. Also, the bilateral symmetrical occurrence of root and canal configuration were investigated. Result Majority of mandibular first premolars (86.7%) and second premolars (98.7%) were single rooted with type I root canal configuration followed by type V (8.6%) in first premolars and type III (0.6%) in second premolars while 3.8% of first premolars and 0.6% of second premolars were two rooted. In first premolars, there was an association between gender with number of roots (p-value = 0.007) and root canal configuration (p-value < 0.001). High degree of bilateral symmetry was seen in both first (85.4%) and second premolars (96.9%) in terms of the number of roots and canal configuration. Conclusion Most of the mandibular premolars were single rooted with Type I canal configuration. However, clinicians should be aware of the variations that may be encountered during routine endodontics which may influence the success behind treatment.