Evaluating key predictors of anatomical complexity in mandibular incisors: insights from CBCT analysis considering premolar anatomy, sex, and age.

Understanding the impact of premolar root anatomy, sex, and age on incisor complexity can aid in developing tailored diagnostic and therapeutic strategies. This study evaluated if the anatomical complexity of mandibular premolars, sex and age can predict the anatomical complexity in mandibular incisors. Using CBCT scans, 3944 mandibular incisors from 493 patients were analyzed. Intra and inter-examiner reproducibility was confirmed using weighted Kappa tests. A mixed predictive model was employed to assess whether premolar root anatomy, sex, or age could predict incisor complexity (α = 0.05). The variables that influenced the presence of complex anatomical morphology in central and lateral incisors were 2^nd premolar, 1^st premolar and sex, increasing the odds that the central incisors had a complex anatomical morphology in 2.16, 1.69 and 0.47 times, respectively. These odds increased 1.86, 1.92 and 0.69 times, respectively for lateral. There was no age association with incisor complexity, suggesting that anatomical complexity is primarily influenced by fixed structural characteristics rather than age-related changes. The anatomical complexity of mandibular premolars and the sex (male) were able to predict the occurrence of anatomical complexity in mandibular incisors.