Canal Morphology Research Articles

Shaping Ability of Reciprocating and Rotary Systems After Root Canal Retreatment: a CBCT Study.

The purpose of this in vitro study was to evaluate the shaping ability of reciprocating and continuous rotary systems after root canal retreatment. After preparation and root canal filling, mesial canals of 54 mandibular molars were distributed into 3 groups (n=18), according to the filling material removal and re-instrumentation protocols: WOG group - WaveOne Gold system; PTN group - ProTaper Next system; and PTU group - ProTaper Universal system. Cone-beam computed tomographic (CBCT) images acquisition of the mesial root canals was performed at different moments: (1) before instrumentation (unprepared root canals), (2) after preparation and filling, (3) after filling material removal and (4) re-instrumentation. The apical transportation (AT), centering ability (CA) and change in root canal diameter were assessed by CBCT analysis. The remaining filling material quantification was performed by radiographic examination. The statistical analyses were performed using the 3-way ANOVA, Tukey-Kramer, Kruskal-Wallis and Dunn multiple Comparison tests (p<0.05). The tested instruments did not show full CA (=1.0). PTN group had greater AT at the 5th mm in comparison with the WOG group (p<0.05). After re-instrumentation, WOG group had greater root canal diameter change at the 1st and 5th mm than PTN and PTU groups (p<0.05). There was no significant difference among groups when comparing the amount of remaining filling material after re-instrumentation (p>0.05). The tested systems provided minimal alteration in root canal morphology at the apical portion after root canal retreatment. However, WOG promoted greater change in root canal diameter.

Management of C-Shaped Canal Morphology in First Mandibular Molar: A Case Report

One of the commonest anatomical variations of the root canal morphology includes the C- shaped canal configuration, frequently observed in second mandibular molars, but may be detected in other tooth morphotypes also. Very frequently, the first mandibular molars necessitate an endodontic therapy as they are often caries-prone and tends to be the first erupting permanent posteriors. The complexities of this root canal diversity might often make canal negotiation, debridement, and obturation cumbersome for the clinician. The detection and exploration of the fan-shaped regions and intricacy of the C-shaped morphology can be enhanced by radiographic and clinical diagnostics. Hand as well as rotary instruments, together with sonics/ultrasonics, could be used to adequately manage this unusual canal arrangement. The current case report describes the diagnosis and management of an unfamiliar C-shaped canal morphology in first mandibular molar and emphasizes the imperative role of CBCT, improved magnifying aids like microscope and good choice of an endodontic sealer for its efficient handling

Morphometric Evaluation of Bony Nasolacrimal Canal in Mongolians with Primary Acquired Nasolacrimal Duct Obstruction

Objectives: To compare the morphometric differences of the bony nasolacrimal canal in unilateral primary acquired nasolacrimal duct obstruction (PANDO) patients between PANDO and non-PANDO sides and the control group in the Mongolian population. Methods: A hospital-based, retrospective case-control design was used for this study. A total of 584 participants were grouped into PANDO patients and the control group. Morphometry of the bony nasolacrimal canal was measured by CT scan. Results: The bony nasolacrimal canal’s minimum transverse diameter was 3.67 ± 1.96 mm on the PANDO side, 3.98 ± 2.01 mm on the non - PANDO side and 4.03 ± 1.12 mm for the control group (p &gt; 0.05). The distal bony nasolacrimal canal transverse diameter was 4.39 ± 1.21 mm for the PANDO side, 4.33 ± 1.32 mm on the non-PANDO side and 5.11 ± 1.25 mm for the control groups (p &lt; 0.05). The bony nasolacrimal canal entrance transverse diameter was 4.36 ± 1.59 mm on the PANDO side, 4.43 ± 1.83 mm on the non-PANDO side and 4.69 ± 1.61 mm in the control group (p &lt; 0.05). Conclusion: Narrower bony nasolacrimal canal morphology may cause a tendency for PANDO development. We identified a narrow distal bony nasolacrimal transverse diameter for both the PANDO and non-PANDO sides of unilateral PANDO patients compared with the control group.

Potential Correlation Between Complicated Root Canal Morphologies of Mandibular Central Incisors and Radix Entomolaris in Mandibular Permanent First Molars in a Turkish Population: A Cone Beam Computed Tomography Analysis

Potential Correlation Between Complicated Root Canal Morphologies of Mandibular Central Incisors and Radix Entomolaris in Mandibular Permanent First Molars in a Turkish Population: A Cone Beam Computed Tomography Analysis

An assessment of morphological patterns and number of canals in mesiobuccal root of maxillary second molars in our patients: Analyzed by Cone Beam Computed Tomography

Objective: To assess the number of canals and morphological patterns of mesiobuccal root of maxillary second molars based on Vertucci’s classification analyzed by Cone Beam Computed Tomography (CBCT) scans in our patients. Study Design: Retrospective Cross sectional analytical study. Place and Duration: At Operative Dentistry Department, Islamic International Dental Hospital, Islamabad from 1st September 2020 to 1st January 2021. Methodology: Cone-beam computed tomography (CBCT) scans (PLANMECA, Finland) were used with image size 13 x 9cm (651 x 651 x 451 cm3), voxel size 200μm to include maxillary anatomy with 96 KV radiation dose, exposure time of 12.527 seconds and current of 9 MA. Slice thickness of 0.200mm was recorded. Axial, coronal and sagittal planes were used to evaluate root canal anatomy of maxillary second molars. Number of canals and morphological patterns as per Vertucci’s classification were recorded in mesiobuccal root of maxillary second molars. Results: Out of 200 cone-beam computed tomography (CBCT) scans, 316 maxillary second molars met the inclusion criteria. Mesiobuccal root of maxillary second molars having one canal were found in 78.48% and 2 canals in 21.52%. Maximum frequencies of canals in mesiobuccal root of maxillary second molars as per Vertucci’s Classification were found to have type I i.e. 78.5% followed by type IV in 16.5% and type II in 5%. Conclusion: Number of canals is variable for the mesiobuccal root of maxillary second molar. Single canal and Vertucci’s type I is the most common canal configuration type in mesiobuccal root of maxillary second molars. Significant difference was found between gender and Vertucci’s classification in mesiobuccal root. Keywords: Cone Beam Computed Tomography, Maxillary Second Molar, Root Canal Morphology

Morphological and topographic evaluation of the mandibular canal and its relationship with the facial profile, skeletal class, and sex.

The aim of this study was to evaluate the morphology and topography of the mandibular canal in patients with different facial profiles, skeletal classes, and sexes. Cone-beam computed tomography volumes of 103 patients were classified according to facial profile and skeletal class. Two examiners classified the mandibular canal into a linear, spoon-shaped, elliptical arc, or turning curvature and measured four related linear distances. The most frequent mandibular canal curvature was identified and multi-way ANOVA with Tukey's test compared the linear measurements between facial types, skeletal class, and sexes (α = 0.05). Kappa and intraclass correlation coefficients were used to assess the reproducibility of qualitative and quantitative variables, respectively. The examiners showed excellent reproducibility. The four curvatures of the mandibular canal were found, but the spoon-shaped and elliptical arch were the most frequent. No significant differences were observed for most of the linear measurements between the different facial profiles, skeletal classes, and sexes (p > 0.05). Spoon-shaped and elliptical arch are the most frequent curvatures of the mandibular canal; furthermore, its morphology and topography seem to be little influenced by the facial profile, skeletal class, and sex.

Assessment of C-Shaped Canal Morphology in Mandibular and Maxillary Second Molars in an Iraqi Subpopulation Using Cone-Beam Computed Tomography

Endodontic treatment is basically dependent on knowledge of the root canal anatomy. The goal of this study was to use cone-beam computed tomography (CBCT) imaging to examine the C-shaped canal configuration of mandibular and maxillary second molars in an Iraqi subpopulation. The prevalence and configurations of C-shaped canals were evaluated in 368 mandibular second molars and 369 maxillary second molars using CBCT scans. The effects of gender, age, and unilateral/bilateral on the presence of C-shaped canals were investigated. Chi-square and Fisher's exact tests were used to determine the level of significance (p ≤ 0.05), and kappa value was used to check reliability of results of the research. In mandibular second molars, the prevalence of C-shaped canals was 17.4%. The prevalence was significantly higher in females (23%) than males (10.4%) using the chi-square test. There is no significant difference in the prevalence of C-shaped canal depending on age and tooth position. The C2 type was the most common (56.3%). This prevalence did not differ with gender, age, or tooth position. In maxillary second molars, C-shaped canals were present in 7.9%. Type I (subtype C) (fusion of 2 root canals MB-DB) was the most common type of fused root (65.5%). There is no significant difference in the prevalence of C-shaped canal depending on the type of fused root, age, and tooth position. The majority of C-shaped canals in mandibular second molars were bilateral in both genders, but unilateral presence was more common in maxillary second molars in both genders. Within the limits of this study, C-shaped canals were found to be more common in mandibular second molars than in maxillary second molars in an Iraqi subpopulation.

An In Vitro Study to Assess the Root Canal Morphology of Human Primary Molars Using Computerised Tomography

Background: A virtuous consideration of root canal morphology is required. Complications all through and after endodontic therapy are frequently caused by variances in the anatomy of root canals in primary teeth. The goal of present study was to determine the number and shape of root canals in primary incisors and molars, as well as the pertinency of cone beam computerised tomography (CBCT) in doing so.Material &amp; Methods:On a total of 60 primary molars and incisors with complete root length, CBCT was used to assess the number of roots, number of canals, width of root canal at cementoenamel junction and middle-third, length and angulations of roots. The information was statistically analysed. Results:The CBCT revealed that 13 percent of mandibular incisors had bifurcation of the root canal in the middle third, while 20% of mandibular molars had two canals in the distal root. The distobuccal root canal diameter of maxillary molars and the mesiolingual canal diameter of mandibular molars were determined to be the smallest.Conclusions:Cone beam computed tomography (CBCT) is a comparatively new and effective technology that can be used in conjunction with conventional radiography to examine variations in root canal morphology in primary teeth.

Root Canal Obturation by Electrochemical Precipitation of Calcium Phosphates

Achieving adequate disinfection and preventing reinfection is the major goal in endodontic treatment. Variation in canal morphology and open porosity of dentine prevents achieving complete disinfection. Questionable biocompatibility of materials as well as a lack of sealing ability questions the usefulness of current obturation methods. With a novel disinfection approach based on the use of boron-doped diamond (BDD) electrodes having shown promising results it was the goal of this series of experiments to investigate the possibility of BDD-mediated in situ forming of a biocompatible obturation material. A combination of calcium phosphate and maleic acid was used as precursor solution while Ion Chromatography Mass Spectrometry (IC-MS), Raman spectroscopy (RAMAN), X-ray diffraction (XRD), energy dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM), dye penetration and micro-computed tomography (µCT) were applied for characterizing the precipitate. It was possible to achieve a BDD-mediated precipitation of brushite in a clinically applicable timeframe. However, tight sealing of the canal system based on brushite could not be achieved.

Root and Canal Morphology of Mandibular Premolars in a Saudi Subpopulation: A Cone-Beam Computed Tomography Study.

Objectives The efficacy of root canal therapy is dependent on a thorough understanding of both normal and aberrant root canal morphology. As a result, the purpose of this study was to use CBCT to characterize the exact root and canal morphology of mandibular premolars in a Saudi subpopulation. Methods The current study included 1000 mandibular premolars (507 first premolars and 493 second premolars) with completely developed roots. CBCT was performed to assess the shape of the roots and to classify the canal anatomy according to Vertucci's classification. The incidence and similarity of the left and right sides, as well as men and women, were investigated. The data were examined using the chi-square test. Results Of the 507 mandibular first premolars analyzed, 484 (95.5%) had one root, whereas 23 (4.5%) had two roots. Of the 493 mandibular second premolars analyzed, 489 (99.2%) had one root, whereas four teeth had two roots (0.8%). There were no statistically significant variations in the number of roots identified across groups (p > 0.05). The most prevalent in mandibular first premolars was type I, accounting for 70.0% (n = 355) of the studied sample, followed by type II (14.2%, n = 72) and type IV (10.1%, n = 51). For mandibular second premolar, type I had the highest incidence (449 (91.1%)), followed by type II (5.7%, n = 28). Conclusion In a Saudi subpopulation, the majority of mandibular first and second premolar teeth had a single root with a type I canal system. On the other hand, numerous roots with various canal classifications were found.

Root and Root Canal Anatomy of Primary Mandibular Central Incisor, Lateral Incisor, and Canine in Indian Children: A Cone Beam Computed Tomography Study.

Background A thorough knowledge of root and root canal morphology in primary dentition is essential for success of endodontic therapy. This information also finds importance in anthropological research in reconstructing human population history. Lack of studies of root and root canal morphology in mandibular anterior teeth prompted us to the present study. Methods A total of 109 extracted primary mandibular incisors and canines were collected, out of which 90 teeth were selected for this study and divided into 3 groups: CI, mandibular central incisor; LI, mandibular lateral incisor; C, mandibular canine. All the sample teeth were scanned using cone beam computed tomography (CBCT). Number of roots, number of root canals, length of root, mesiodistal (MD), and buccolingual (BL) width of canal, shape of canal, and presence of accessory canals were assessed. Collected data were statistically compared using one-way ANOVA and chi-square tests. Results All teeth studied displayed single root with single root canal conforming to type I Vertucci's classification. Root length of CI was significantly shorter than both LI and C, with no significant difference between LI and C. Straight root canals were more common in CI and LI, whereas curved canals were more common in C. S-shaped canals were seen in a few CI and C. BL canal width was more than MD width in all teeth, C showing significantly larger dimensions than both CI and LI. Conclusion This study presents root and root canal characteristics of primary mandibular central incisor, lateral incisor, and canine in children from Indian ethnicity.

Prevalence and morphology of C-shaped and non-C-shaped root canal systems in mandibular second molars.

There are no cone-beam computed tomography (CBCT)-based data on the anatomy of mandibular second molars in an Australian population. This study investigated the prevalence and descending morphology of mandibular second molars with and without C-shaped canals using retrospective analysis of CBCT scans. Scans from 715 patients were screened for the presence of C-shaped canals and assessed for cross-sectional configuration at five axial levels. Non-C-shaped molars were assessed for other morphological characteristics. Data were modelled against patient, tooth and CBCT scan characteristics. A total of 1278 teeth from 657 patients were evaluated. The overall prevalence of C-shaped canals was 13%. Cross-sectional configuration of C-shaped canals was variable, with an average of 2.8 unique cross-sections per tooth. Non-C-shaped teeth were predominantly Vertucci Type II (60%) and Type IV (29%) configurations in mesial roots, and Type I (91%) in distal roots. Additional roots occurred in 4.3% of teeth and there was a significant association between radix paramolaris and distal root bifurcation (P &lt; 0.001). Cross-sectional analysis confirmed the complexity and variability of C-shaped canals. Clinicians should be cognizant of the prevalence and variability of C-shaped root canal morphology and how this may affect endodontic treatment.

Deviant morphology of the root canal system in mandibular premolars: clinical cases.

Numerous cases of aberrant root and root canal morphology have been described, still diversion occurs more frequently in premolars and molars. To the dental researcher, the aberrations in the mandibular second premolars afford a vast field of interest. The current report presents a clinical case which demonstrates a simplified therapeutic protocol for re-treatment of Vertucci type V root canals. Endodontic access is gained by expanding the endodontic cavity. The instrumentation (preflaring and final preparation) of the root canal system is performed using predominantly hand files in order to preserve to the maximum the tactile feedback in the apical part of the ramification. Obturation is performed through hydraulic condensation. Postoperative radiographs show sufficient three-dimensional sealing of all portals of exit with excellent healing result.

Anatomical Evaluation of Mandibular Premolars in Saudi Population: An In Vivo Cone-beam Computed Tomography Study

Background: Cone-beam computed tomography (CBCT) offers a three-dimensional (3D) image of the anatomical structures in the maxillofacial region. CBCT can provide images with sufficient spatial resolution and low radiation dose in endodontic diagnosis and treatment planning. Objective: This study aimed to evaluate the root canal morphology of mandibular premolars in a Saudi sub-population by showing the importance of cone-beam computed tomography radiographic analysis in detecting varieties of the root canal system. Methods: A total of 776 mandibular first and second premolars were analyzed. Teeth that have completed root development and apical closure were included. To accurately evaluate the external and internal morphologies of the teeth, three sections (i.e., the serial axial, coronal, and sagittal sections) were acquired for each tooth. Data are presented in terms of frequencies and percentages. The chi-squared test was used to determine the differences between two sides (right and left). A p-value of less than 0.05 was considered statistically significant. Results: Among the 397 mandibular first premolars, 99.5% had one root, 69.5% had one canal, and 29.5% had two canals. In terms of root canal configuration, 69.5%, 6.3%, 22.2%, and 0.3% of the teeth had Vertucci type I, type III, type V, and type VII canal configurations, respectively. Similarly, among the mandibular second premolars, 100% had one root, 96.8% had one canal, and 2.1% of teeth had two canals. Most of the samples (96.8%) had Vertucci type I canal configuration, and 1.6% and 0.8% of the teeth had Vertucci type III and type V canal configurations, respectively. In both groups of teeth, no statistically significant differences were observed between the right and left sides (P&gt; 0.05). Conclusion: Mandibular premolars could have challenged internal morphology, and CBCT small field of view is advised in case periapical x-ray is inconclusive.

Nasolacrimal canal morphology with or without idiopathic obstruction in Caucasian adults: a multidetector CT study.

To compare the morphological features of the bony nasolacrimal canal (NLC) in Caucasian adults with and without primary acquired nasolacrimal duct obstruction (PANDO). The study included one eye each from 38 patients with PANDO and 38 age- and gender-matched controls without PANDO, all of whom underwent multidetector computed tomography. In tomographic images, length, and orientation angles of the NLC, transverse canal diameters at the duct entrance and lower end, and minimum (narrowest) transverse and anterior-posterior canal diameters were measured. The two groups were similar for NLC length and angulations. The transverse entrance diameter was significantly narrower in the PANDO group (mean, 4.6mm vs. 5.1mm) (p = 0.09). The narrowest site was most frequently in the middle duct or slightly above the middle in both groups (p > 0.05). The minimum canal diameters were significantly smaller in the PANDO group (p = 0.010 and p = 0.003). When gender subgroups were compared, the significant differences continued for the transverse entrance and minimum diameters in females with PANDO (p = 0.006) and for the minimum anterior-posterior diameter in males with PANDO (p = 0.02). Narrowness of the upper and/or middle part of the bony nasolacrimal duct may play a role in the development of PANDO in the adult Caucasian population.

Minimally invasive treatment of calcified root canals in anterior teeth with digital guide technique.

This study aims to establish a minimally invasive treatment using a customized digital template and a miniaturized bur for pulp canal obliteration (PCO). Cone-beam computed tomography (CBCT) and digital oral scans of patients diagnosed with PCO in anterior teeth were obtained. Root canal morphology was reconstructed to accurately show the location, length, and direction of obliteration. A digital template was designed and fabricated using visual design software and 3D printing technology and used as guide for the miniaturized bur and drill sleeve during calcified tissue removal. A conventional root canal treatment was performed after the lumen of the root canal was reached. In both cases, the planned access cavity and glide paths were successfully established. In case 1, the deviated angle of the access cavity was 1.37°±0.07°, the deviation at the bottom of the miniaturized bur was 0.08-0.81 mm, the deviation at the tip of the bur was 0.05-1.13 mm, and difference in substance loss was 0.84-4.25 mm³. In case 2, the deviated angle of the access cavity was 3.09° ± 0.12°, the deviation at the bottom of the bur was 0.09-0.68 mm, the deviation at the tip of the bur was 0.29-0.66 mm, and the difference in substance loss was 0.55-3.79 mm3. Micro-guided endodontics is a novel approach for localizing and negotiating obliterated root canals and guarantees long-term prognosis without requiring excessive hard tissue removal.

Morphological Study of Root Canals of Maxillary Molars by Cone-Beam Computed Tomography.

The aim of this study was to evaluate the root canal morphology of permanent maxillary molars by cone-beam computed tomography (CBCT) using the classifications of Weine et al. and Vertucci and to correlate the findings with sex, age, position in the dental arch, and prevalence of a second canal in the mesiobuccal root (MB2). A total of 414 scans were evaluated, corresponding to 1,000 teeth. The assessment consisted of coronal, axial, and sagittal reconstructions using i-CAT Workstation®. Type 0 was assigned when neither classification could be applied. The data were entered into an Excel spreadsheet and analyzed using SPSS. The chi-squared test or Fisher's exact test was used to compare the distribution of root canal morphology classified using the two systems. Analysis of the distribution of Weine types showed a predominance of type III in mesiobuccal roots, while type 0 predominated in distobuccal and palatal roots. Vertucci type IV predominated in mesiobuccal and distobuccal roots and type VII in palatal roots. There was no difference in the distribution of morphological canal types in permanent maxillary molars evaluated by CBCT according to sex, age group, or position in the dental arch of the patients. MB2 canals were identified in 68.4% of the teeth evaluated.

Anatomical Evaluation of Root and Root Canal Configuration of Permanent Maxillary Dentition in the Population of the Kingdom of Saudi Arabia.

Aim This study is aimed at combining the sample sizes of all studies on permanent maxillary teeth conducted in different regions of the Kingdom of Saudi Arabia (KSA) to obtain a large sample size that represents the population of the KSA. The outcome of these combined studies is compared with international studies in terms of the number of roots, number of canals, and canal configurations on the basis of Vertucci's classification. Methodology. The studies were systematically reviewed using the Preferred Reporting Items for Systematic Review and Meta-analysis chart. Studies were included in the analysis if they were conducted in the KSA, involved permanent human maxillary teeth, and had a sample of more than 10 teeth (power). By contrast, studies were excluded if they involved deciduous teeth in the sample size, investigated nonhuman teeth, were not conducted in the KSA, and were case reports, case series, review studies, and anomalies. Relevant literature was searched from PubMed, Scopus, Web of Science, Embase, Cochrane, and Direct Science by two calibrated teams, starting in August 2020, without time limits or language restrictions. Results The database searches and cross-referencing identified a total of 19 relevant studies. All maxillary canines (N = 1,018) had one root, whereas 98.4% had one canal and 98.3% had Vertucci type I. Moreover, 63.2% of the maxillary first premolars had two roots, and 91.4% had two canals. The most common Vertucci root canal configuration was type IV (64.6%). The maxillary second premolars mostly had one root (84.4%) and one canal (50.4%). The most common canal configuration was Vertucci type I (47.1%). The majority of maxillary first molars had three roots (98.9%), 48.7% of which had three canals, and 46.4% had four canals. The most prevalent feature of the canal morphology of mesiobuccal roots was Vertucci type II (35.3%). The investigated maxillary second molars had three roots, 88.0% of which had three canals. Conclusion This systematic review represents the Saudi population since samples were combined from different studies from different regions of the country. Variations in findings were observed in the same group of teeth from different regions and the same region, while the overall combined samples results fell within the range of other international studies.

Morphology of human ear canal and its effect on sound transmission.

The ear canal (EC) is essential for sound transfer and crucial for hearing. Some pathological conditions may modify its morphology, leading to EC sound pressure redistribution, and stapes footplate displacement (FPD) gain alteration. However, no consensus regarding pathological EC and its impact on sound transfer has yet been achieved. To address the effect of morphology of EC on sound pressure redistribution and FPD gain. Varied pathological EC finite element (FE) models were constructed and analyzed based on FE analysis. The results indicated that canal wall down mastoidectomy decreases the second resonance frequency of the EC. The canal wall down mastoidectomy, with conchaplasty increased the first resonance frequency, but decreased the second along with the interval sound pressure gain increased, following which the FPD gain was altered. Stenosis of the EC at the internal portion decreased the second resonance frequency with minimal effect to the first part. When the stenosis moved to the outer portion of the EC, the first resonance frequency decreased, and the second one increased, along with the interval sound pressure gain decreased and FPD gain. Finally, the simplified EC model exerted a minimal effect on sound transfer. The minimal change in EC, such as simplification, straightening, canal wall down mastoidectomy, or enlargement, moderately affects the sound transfer; however, the EC stenosis deteriorates the sound transfer remarkably.

A study of mandibular premolar root and canal morphology in a Black South African population using cone-beam computed tomography and two classification systems.

An investigation of the configurations of mandibular premolar roots and canals in a population of Black South Africans. Cone-beam computed tomography analysis of 772 mandibular premolars was performed, and the premolars were classified according to the systems proposed by Vertucci and Ahmed et al. Root number, canal morphology, age, and sex were recorded. Fisher's exact test was used to determine relationships based on age and sex (P < 0.05). Single roots were seen in the majority of mandibular premolars (97.1%). Single canal configurations (i.e., Vertucci Type 1/Ahmed et al. 1MP1) were observed in 48.5% of first and 81.3% of second mandibular premolars. Mandibular first premolars demonstrated multiple canals in more than half of the sample (51.5%), and C-shaped morphology in more than one-tenth (11.1%). A relationship between sex and the presence of radicular grooves was demonstrated (P = 0.049), males being more likely to demonstrate this feature (P = 0.051). Multiple canals in mandibular first premolars also showed a relationship with sex (P = 0.005), a male predilection being evident (P = 0.007). The Ahmed et al. system proved superior to the Vertucci classification for reporting complex configurations and anatomical variations, although a greater number of unique categories were created. Diverse mandibular premolar root and canal morphology was observed in the studied population. Clinicians must be aware of common morphological features as well as possible anatomical variations in mandibular premolars, as failure to treat complete root canal systems may negatively impact endodontic treatment outcomes.