Prevalence of a Second Root and Canal in Mandibular and Maxillary Canines in a Saudi Arabian Population: A Cone-beam Computed Tomography Study

Abstract

This study evaluated the prevalence of a second root and canal, gender differences, and bilateral symmetry of mandibular and maxillary permanent canines in a Saudi Arabian population using a cone-beam computed tomography (CBCT). The first step was to evaluate CBCT images of 208 patients with 794 canines (410 mandibular and 384 maxillary canines). The second step was to identify the number of roots, number of canals, and canal configurations based on Vertucci's classification to investigate the prevalence of a second root and a second canal, gender differences, and bilateral symmetry. A Z test evaluated differences in the independent proportions; a Chi-square test determined differences between genders and Cohen's Kappa test assessed bilateral symmetry. The prevalence of two roots and two canals in mandibular canines was 2.7% and 9.3%, respectively, and Vertucci's type III appeared in 6.1%, and Vertucci's type V appeared in 3.2%. In maxillary canines, there were no two-rooted teeth, and only 1% of two canals were present with Vertucci's type III. There were no statistically significant differences between genders in both mandibular and maxillary canines. High bilateral symmetries of roots and canals appeared in mandibular canines (95.5% and 91.1%, respectively) and maxillary canines (100% and 98.9%, respectively). One root, one canal, and Vertucci's type I are the primary and typical characteristics of mandibular and maxillary canines. The presence of a second root in mandibular canines is small, although the presence of two canals is not unusual. Conversely, it is rare to find a second root and canal in maxillary canines. Mandibular canines showed bilateral asymmetry (8.9%) in the number of canals between the right and left sides, which could be of clinical importance when planning root canal treatment (RCT) on contralateral canines.