Root Canal Morphology Research Articles

Endodontic management of distinctive anatomic aberration with maxillary 1 molar -a case report of three mesiobuccal canal on one side and taurodontism on contralateral arch

The present case describes root canal treatment in a maxillary first molar with unusual anatomy of MB3 canal in one arch and Taurodontism on the contralateral arch. Understanding the differences in root canal morphology is crucial to the success of endodontic treatment. Taurodontism in the contralateral maxillary molar is an uncommon condition. A male patient was referred for the treatment of maxillary right and left first molar tooth. Clinical examination of the pulpal floor revealed 3 orifices in the mesio-buccal root in #16 while Taurodontism in #26. The tooth was treated successfully. Anatomic variations must be taken into consideration in clinical and radiographic evaluation during endodontic treatment.

Endodontic Management of Failed Root Canal Treatment in Teeth With Previously Missed Canals: A Report of Two Cases With Rare Root Canal Morphology

Endodontic Management of Failed Root Canal Treatment in Teeth With Previously Missed Canals: A Report of Two Cases With Rare Root Canal Morphology

Radicular Dentin Thickness and Root Canal Morphology of Mandibular Incisors in Indian Subpopulation Using Cone Beam Computed Tomography

Radicular Dentin Thickness and Root Canal Morphology of Mandibular Incisors in Indian Subpopulation Using Cone Beam Computed Tomography

Three-dimensional assessment of root canal morphology of primary dentition using cone beam computed tomography.

Root canal therapy in primary teeth is exceedingly complex due to the unique internal geometry of the pulp cavity. The purpose of this study was to evaluate variations in primary teeth root canal morphology and applicability of the Ahmed etal. (Int Endod J, 50, 2017, 761) alphanumeric system for classifying them. A retrospective analysis of 2024 primary teeth from an existing CBCT database was performed for assessing variations in root canal morphology. Descriptive statistics and the chi-squared test were used for data analysis. The maxillary canines exhibited splitting levels of 5.9% (right) and 6.6% (left), and merging levels of 1% (both sides); maxillary lateral incisors showed splitting levels of 2.6% (right) and 0.8% (left), with no merging observed; mandibular second molars had splitting levels of 1.5% (right) and 0.8% (left), with no merging observed; and mandibular lateral incisors exhibited a merging level of 0.9% (right), with no splitting observed. This study provides new insights into the variations in root canal morphology of primary teeth, particularly highlighting the variations found in primary canines. The Ahmed etal. (Int Endod J, 50, 2017, 761) classification system was found to be a useful tool for categorizing these variations.

Root Canal Morphology of Premolars in Population of Hyderabad, Pakistan: A Cone Beam Computerised Tomographic Analysis.

To investigate the mean tooth length and root canal configuration of human maxillary and mandibular premolars in the population of Hyderabad, Pakistan, using Cone Beam Computed Tomography (CBCT). Observational study. Place and Duration of the Study: Department of Operative Dentistry and Endodontics, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan, from December 2022 to March 2023. Using retrospective analysis of CBCT scans, tooth length, the number of roots, and root canal configuration of 536 mandibular and maxillary premolars were assessed in the subpopulation of Pakistan. The data were analysed employing descriptive statistics, Chi-square tests, and One-Way ANOVA to determine the association between various factors and root canal morphology. Vertucci Type 1 (one canal) was the most common configuration in maxillary premolars, with frequencies ranging from 46.3 to 52.2%. The mean length of all 8 premolars ranged from 20.56 mm to 21.58 mm. C-shaped canal configurations were observed in a small percentage of maxillary and mandibular premolars, with C1 being the most common. No significant association was found between gender and canal configuration or tooth length, and in tooth lengths among different canal configurations. Vertucci Type 1 was the most common configuration in maxillary premolars, followed by Vertucci Type 4. Single-rooted premolars were more prevalent, while two-root configurations were less common. C-shaped canal configurations were observed in a small percentage of premolars, with higher frequency in mandibular premolars. Cone beam computed tomography, Dental anatomy, Endodontics, Premolars, Root canal morphology.

Morphology and root canal configuration of maxillary lateral incisors: a systematic review and meta-analysis.

The purpose of this study was to explore maxillary lateral incisors (MxLI) intern morphology by analyzing existing literature. We searched five electronical databases (Cochrane, Embase, LILACS, Scopus, MEDLINE via PubMed) using keywords and predefined search terms. Additional studies were identified by cross-referencing and reviewing bibliographies of relevant articles. From 92 initial studies, 27 duplicates were removed, and 65 records screened. After full-text review and hand searching were 19 studies included. The most reported root canal configurations (RCC) of MxLI were Vertucci (Ve) I (1-1-1/1; 78.1-100%), Ve II (2-2-1/1; 0.2-5%), Ve III (1-2-1/1; 0.1-14.6%), Ve IV (2-2-2/2; 0.5%), and Ve V (1-1-2/2; 0.5-4.9%). A meta-analysis of six studies from Europe and Asia indicated sex-differentiated patterns in RCC prevalence: higher occurrences of Ve II (2-2-1/1; OR [95%CI] = 1.19 [0.51, 2.73]), Ve III (1-2-1/1; (OR [95%CI] = 1.72 [0.61, 4.85]), and Ve V (1-1-2/2; (OR [95%CI] = 2.95 [1.02, 8.55]) configurations were noted in males, whereas females predominantly exhibited Ve I (1-1-1/1; [95%CI] = 0.99 [0.97, 1.02]), and Ve IV (2-2-2/2; (OR [95%CI] = 0.11 [0.01, 2.02]). Examination methods varied, with cone beam computed tomography (CBCT) being most commonly (n = 11), followed by staining & clearing (n = 5), and radiographic analysis (n = 1). The predominant RCC in MxLI is type Vertucci I. CBCT is the most common method for assessing the morphology of root canals. However, up to 20% of cases may present with complex and sex-specific patterns, highlighting the need for clinicians to be aware of these differences to prevent complications during endodontic treatments.

Evaluation of Root Canal Morphology of the Maxillary Permanent First Molar among Iraqi Population: A Cone Beam Computed Tomography Study (Retrospective Study)

Purpose: Endodontic success mainly depends on the complete root canal system debridement, both mechanically and chemically. The maxillary first molar possesses one of the most complex root canal anatomy. The purpose of this study was to map the maxillary first molar's root canal anatomy and its variations. Cone Beam Computed Tomography (CBCT) was used to determine the prevalence of the Second Mesiobuccal Canal (MB2) and its possible relation to the gender of the patient in the Iraqi population. Materials and Methods: Images from documented archives of CBCT scans for 415 patients who had maxillofacial diagnosis or root canal treatment were used in this study. Totally 656 maxillary first molars (336 females and 320 males) were included. The root canal configuration, frequency of MB2, and its two-sided symmetry were observed. The (chi-square test) was used to calculate the gender correlation. The P-value of less than 0.05 (p < 0.05) was considered significant. Results: In 61.1% of the cases, the MB2 canal was discovered with high bilateral symmetry (73.6%). Genders did not show any statistically significant differences. Conclusion: The existence of MB2 canal in the maxillary first molars is high and approximately more than half of the cases. No relation was found between the existence of the MB2 canal and the gender of the patient. CBCT is a clinically efficient method for the diagnosis and improvement of root canal therapy.

Root canal morphology of mandibular anterior permanent teeth in Turkish sub-population using two classification systems: a cone-beam computed tomography study.

This study examined the root and canal morphology of mandibular anterior teeth (MA) in the Turkish sub-population using cone-beam computed tomography (CBCT), comparing the findings based on Vertucci's and Ahmed et al. classification systems. The CBCT images were acquired using the 3D Accuitomo CBCT device. Images that were deemed suitable for visualizing the roots, canals, and the complete pulp chamber and apex were included in the study. Vertucci and Ahmed et al. classification systems were employed to determine the root canal morphology. 500 CBCT images and 3000 teeth were analyzed. Type I (1MA1) was the most frequent, followed by Type III (1MA1-2-1). 3.8% of teeth could not be classified with Vertucci system. In canine teeth, Vertucci type III (1MA1-2-1) was significantly more prevalent in males than females (p = 0.038) and Type I (1MA1) was less frequent in individuals aged 41-50 (p < 0.05). Canal divergence/merging was the most common at the middle/apical level for central (15.5%) and lateral (10.3%) teeth, and at the coronal/middle level for canine teeth (1.9%). Bilateral similarity was high for all tooth groups (> 78%). One-third of mandibular incisor teeth have two canals, with a significant number exhibiting canal divergence/merging that was separated in the middle region and merged in the apical region. The Vertucci classification was found to be inadequate in some cases, while Ahmed et al. classification was able to classify all mandibular incisors with a single code. Ahmed et al. classification is a more useful system for classifying all MA.

Exploring the Root Canal Morphology of Third Molars in the Bosnia and Herzegovina Population.

The objective of this study was to evaluate the root canal morphology of third molars in the Bosnia-Herzegovina population. A total of 241 extracted third molars (105 maxillary and 136 mandibular) were subjected to a clearing procedure. The specimens were categorized into ten groups based on the Alavi classification for maxillary third molars (MaxTMs), and six groups were based on the Gulabivala classification for mandibular third molars (ManTMs). Root canal type according to the Vertucci classification, the presence and position of lateral canals, and intercanal communication were analyzed using a stereomicroscope x15. MaxTMs had three roots in 77.13% of the samples. Among MaxTMs, the most common morphology was three fused roots (33.33%) and Vertucci's type VIII (54. 28% of samples in Alavi's Group IV). 60.29% of ManTMs have two separate roots (Gulabivala's Groups II and III). The most prevalent types in mesial roots were type I (41.46% in Group II) and type IV (48.78% in Group III), although type I predominated in distal roots (91.24% and 100% in Groups II and III, respectively). Single-rooted third molars usually have a root canal morphology that is more favorable for endodontic treatment. In contrast, third molars with fused roots often have more complex root canal morphology.

Assessment of cone beam computed tomography use in pediatric and adolescent patients: a cross-sectional study

BackgroundThe use of cone beam computed tomography (CBCT) for dentomaxillofacial diagnostics in pediatric dentistry is expanding and concerns have been raised about the radiation risks associated with this imaging modality, especially for children. Dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks (DIMITRA) is a multidisciplinary project focused on optimizing CBCT exposure for children and adolescents. This study aims to clarify the indications behind CBCT scans in children aligned with DIMITRA’s recommendations.MethodsFor each CBCT examination, data were collected on patient age at the time of the CBCT examination, gender, reason for request, referring department, CBCT-requested region, and the field of view (FOV) dimension of imaging. The CBCT indications were categorized under six headings according to an adaptation of the DIMITRA project recommendations: impacted teeth, dentoalveolar trauma, orofacial clefts, dental anomalies, bone pathology, syndromes. Indications not categorized in DIMITRA were recorded below the heading “other”.ResultsThe most common indication was the “other” category (34.8%), which included implant, temporomandibular joint dysfunction, orofacial anomalies, foreign object and root canal morphology. The least common indication was “orofacial cleft” (1.9%) and no requests were made for cases related to syndromes. Detection of supernumerary tooth in dental anomalies (68.6%) was the most common CBCT indication, while dentigerous cysts (37.6%) were among the most common CBCT indication in bone pathologies and orofacial anomalies (68.1%) in the other category. The most common size was External Center (15 × 15 cm) (27%) and the least common size was Both Arches/small (8 × 8 cm) (0.4%) when the CBCT FOV was analysed.ConclusionsAlthough the option of a smaller FOV size was available, the larger FOV size that included the both jaws were most frequently used. When justifying CBCT requests, patient-specific radiation dose risks should be considered and specific guidelines should be followed.

Evaluation of root and root canal morphology in maxillary premolar teeth: A cone-beam computed tomography study using two classification systems in a Japanese population

Background/purposeInadequate knowledge increases the risk of overlooking root canals and causing procedural errors that can lead to root canal treatment failure. This study aimed to analyze the root and root canal morphology in maxillary premolar teeth using two classification systems assessed by cone-beam computed tomography (CBCT) in a large Japanese population. Materials and methodsThis study evaluated 1443 maxillary teeth including 726 first and 717 s premolars, from 642 Japanese individuals aged 16–84 years. CBCT images were analyzed according to the Vertucci and Ahmed classification systems, focusing on the root and root canal morphology. Variations were analyzed based on gender and age using the chi-square test (P < 0.05). ResultsMaxillary first premolars were predominantly single-rooted (64.9%) and had two root canals (86.2%). Females exhibited a higher prevalence of single-rooted (71.0%) compared to males (49.8%) (P < 0.05). Additionally, single root canals occurred significantly more frequently in females (14.0%) than in males (7.5%) (P < 0.05). Maxillary second premolars mostly had a single root (97.8%) with a single root canal (72.1%). The frequency of second premolars with two root canals significantly increased with age (P < 0.001). The three-rooted configuration occurred in 1.2% and 0.3% of the first and second premolars, respectively. ConclusionMaxillary premolars in a Japanese population showed significant anatomical variations, highlighting the importance of understanding anatomical characteristics specific to age and gender. Ahmed's system provides a more comprehensive description of the morphological variations.

Exploring Variation in Root Canal Morphology of Maxillary Second Premolars: A Cone-Beam Computed Tomography Study in a Pakistani Subpopulation

A comprehensive knowledge of anatomy of roots and root canals was a key for successful treatment outcomes. Maxillary second premolars often display variability in root and canal numbers. Traditional 2-dimensional imaging techniques have limitations in exact diagnosis of dental anatomy, encouraging the practice of Cone Beam Computed Tomography (CBCT) for comprehensive three-dimensional imaging. Objective: To explore the variations in the number of roots and root canals in maxillary second premolars using CBCT. Methods: The current study was a retrospective study and conducted at the Radiology department of Fatima Memorial College of Dentistry, Lahore. A total of 143 CBCT scans with completely formed roots were included. Data were analyzed using Planmeca Romexis imaging software and statistical analysis was performed using SPSS version 23.0. Results: Among 143 individuals, the majority exhibited one root and one canal in maxillary second premolars. In terms of root number, 77% of the 2nd premolars had a single root and 23% had two roots. In relevance of root canals, 62.5% were found to have a single canal and 37.5% had two root canals. However, no any case was found having three roots and canals. Bilateral symmetry in root canal patterns was observed in most cases, with statistically significant differences between genders. Conclusions: The findings of this study may contribute to the understanding of variations in dental anatomy in Pakistani population and emphasize the importance of one’s treatment approaches for optimal patient care.

Quantitative statistical evaluation of maxillary and mandibular incisor root canal morphology in Saudi patients

Abstract Introduction: Clinical practice demands understanding the complexity of the root canal system to achieve desired treatment goals. The statistically detailed morphology of the tooth and root canal morphology is very important to know. Therefore, the present study aims to investigate the statistical analysis of root canal morphology and morphological variations of maxillary and mandibular incisor teeth using cone-beam computed tomography (CBCT) in Saudi patients attending King Saud University Dental Hospital. Materials and Methods: CBCT images of 480 patients were selected. Number of roots and root canal configuration were identified and categorized according to Vertucci’s classification. Tooth length, distance from cementoenamel junction (CEJ) to the area of canal division, and width of the canal at the area of division were also evaluated. Bilateral symmetry and association between gender and age with the different variables were investigated. Data were analyzed using Chi-square, multiple linear regression, and McNemar’s tests. Results: A total of 3412 teeth were evaluated. All maxillary teeth had one root with Type I canal configuration. For mandibular teeth, all exhibited one root with the majority having Type I canal configuration in central (71.2%) and lateral (75%) incisor teeth. There was a statistically significant association between number of canals and age in mandibular incisor teeth observed only in females (P &lt; 0.001), while no association was observed between canal configuration and gender (P = 0.900 and P = 0.721, respectively). Multiple regression analyses showed that age and gender significantly explain the difference of the variance in tooth length (P &lt; 0.001). Moreover, bilateral symmetry was observed in 98.1% of mandibular central and 97.6% of lateral incisor teeth with no statistically significant association (P = 1 and P = 0.058, respectively). Conclusion: All maxillary and most mandibular incisor teeth present with one root and Type I canal configuration. In general, males have longer teeth than females, with a significant decrease in length with each year increase in age. Mandibular lateral incisor teeth exhibited the highest mean distance from CEJ to point of canal separation and highest mean width in the area of canal division.

Position and frequency of lateral canals in carnassial teeth of dogs

Carnassial teeth, as one of the most important teeth in dogs, are commonly affected by different types of injuries and pathological disorders, which require endodontic treatment. Lateral canals, which leave the main root canal, and apical deltas are present in the root canal system of dogs. These canals represent small branches that leave the main root canal at a sharp angle and terminate in a region of the periodontal ligament on the external root surface. In this study, 200 teeth were included, of which 100 were superior fourth premolars and 100 were inferior first molars. Lateral canals were present in a total of 30 roots of superior fourth premolar teeth, whereas in inferior first molars, these canals were found in 3% of roots. In superior fourth premolars, lateral canals were mostly present in the apical third, 86%, while 14% were present in the middle third of the root. In inferior first molars, lateral canals were found in 3% of the roots, 2% in the apical third and 1% in the middle third of the roots. The knowledge of the complex root canal morphology is essential for any endodontic treatment. Due to the presence and frequency of lateral canals, it is imperative to perform more thorough cleaning and instrumentation while performing endodontic treatment on superior fourth premolars compared to inferior first molars.

Root canal morphology of permanent mandibular anterior teeth in a Pakistani population: A cone beam computed tomography assessment.

To investigate the incidence of accessory canals and the variation in root canal morphology of permanent mandibular incisors and canines in Pakistani population using Cone Beam Computed Tomography (CBCT). A cross-sectional study was conducted in University College of Dentistry, The University of Lahore, Pakistan after getting institutional ethical permission from January 2020 to September 2022. The data included records of 111 patients consisting of 444 permanent mandibular incisors and 222 permanent mandibular canines. Accessory root, root canals and Vertucci canal configuration for each tooth was recorded. Data analysis was done using SPSS v20. Descriptive statistics were calculated for each anatomical parameter. Chi-square test was applied to determine association of gender with the presence of accessory roots and root canals. Among the 111 records evaluated, 48.6% were males and 51.4% were females. No accessory root was found in the central and lateral incisors. However, an accessory root was found in 4.9% of the canines. The incidence of accessory canals in the central incisors, lateral incisors and canines was 18.9%, 25.2% and 10.4% respectively. The most common canal configuration in teeth with accessory canals was Type-III, followed by Type-II and Type-V. None of the central or lateral incisor showed accessory root while it was detected in 4.9% canines. The frequency of accessory root canal was found to be 18.9%, 25.2% and 10.4% in central incisors, lateral incisors and canines respectively. The most common canal configuration was Type-I, followed by Type-III and Type-II. Type-V, VI and VII were less common.

Prevalence of Middle Mesial Canal in Mandibular First Permanent Molars in a Persian Population: An In Vivo Cone-Beam Computed Tomography Study.

This study aimed to identify the prevalence of the middle mesial canal (MMC) in mandibular first permanent molars in a Persian subpopulation sample using cone-beam computed tomography (CBCT). The secondary aim was to correlate the incidence of MMC with variables such as gender, age, and the presence of an additional distal canal. A total of 390 mandibular first molars from 314 CBCT images were retrospectively evaluated. The presence of the MMC was recorded while considering related factors such as additional distal canal and demographic information of the patients (age and gender). Fisher's exact tests and independent-samples t-test were used for the statistical comparisons with a significance level of 0.05. Among 390 mandibular first molars, 34 teeth contained an MMC (8.7%). The number of teeth with the MMC in women was equal to that of men. There was no significant difference between the two genders in the prevalence of the MMC (p > 0.05). The prevalence of patients' MMC had no significant relationship with their age (p > 0.05). However, there was a significant association between the presence of the MMC and an additional distal canal (p < 0.05). The incidence of an additional distal canal in teeth with a diagnosed MMC was statistically significant. The prevalence of the MMC in mandibular first molars in the study population was low; however, accurate knowledge of root canal morphology in terms of the presence of an additional root canal in these teeth should be considered.

Artificial intelligence in endodontics: Data preparation, clinical applications, ethical considerations, limitations, and future directions.

Artificial intelligence (AI) is emerging as a transformative technology in healthcare, including endodontics. A gap in knowledge exists in understanding AI's applications and limitations among endodontic experts. This comprehensive review aims to (A) elaborate on technical and ethical aspects of using data to implement AI models in endodontics; (B) elaborate on evaluation metrics; (C) review the current applications of AI in endodontics; and (D) review the limitations and barriers to real-world implementation of AI in the field of endodontics and its future potentials/directions. The article shows that AI techniques have been applied in endodontics for critical tasks such as detection of radiolucent lesions, analysis of root canal morphology, prediction of treatment outcome and post-operative pain and more. Deep learning models like convolutional neural networks demonstrate high accuracy in these applications. However, challenges remain regarding model interpretability, generalizability, and adoption into clinical practice. When thoughtfully implemented, AI has great potential to aid with diagnostics, treatment planning, clinical interventions, and education in the field of endodontics. However, concerted efforts are still needed to address limitations and to facilitate integration into clinical workflows.

Comprehensive analysis of root canal morphology in maxillary premolars among the Pakistani subpopulation: a CBCT-based study

BackgroundUnderstanding the root canal morphology is essential for the success of root canal treatment. Therefore, this study aimed to evaluate and analyze the root canal configuration of maxillary premolars using Cone Beam Computed Tomography in the Pakistani subpopulation.MethodThis cross-sectional study utilized CBCT scans from two distinct centres: Aga Khan University in Karachi and Jinnah MRI and Body Scans in Lahore. The CBCT images were visualized using GALAXIS version 1.9 (SICAT GmbH and Co. KG, Bonn, Germany), integrated within the Sirona Dental System (D-64625 Bensheim, Germany). The scanning parameters were standardized at 85 kV, 7 mA, with a 15-s exposure time and a voxel size of 0.16 mm. A total of 707 CBCT scans were collected, encompassing 2180 maxillary premolars. Root canal configurations were classified based on (Ahmed et al. Int Endod J. 2017;50(8):761–70). Statistical analyses were performed using SPSS version 26, employing the Chi-square test with a significance level set at p < 0.05.ResultsThe distribution of root canal morphologies varied significantly with age and gender. Among maxillary premolars, 50% exhibited the typical configuration of 2MPMB1 L1 (two roots, single canal in each buccal and lingual root), while 26% of maxillary right second premolars displayed 1MPM1 (one root, one canal). Overall, 1MPM1 accounted for 27.4% of the total cases in the second premolars. There was no statistically significant relationship between age and root canal distribution in either first premolars (p = 0.338) or second premolars (p = 0.833). Regarding gender, a significant difference was observed in the distribution of right maxillary 1st premolars (p = 0.022*), with a higher prevalence among females.ConclusionThis study offers significant insights into the anatomical variations of root canals in maxillary premolars across diverse regional subpopulations in Pakistan. While specific root canal configurations were prevalent, the findings indicate no statistically significant correlation between age and root canal morphology in maxillary premolars. However, a notable gender disparity was observed in the distribution of the right maxillary first premolars.

The Essential Guide to Managing morphological oddity of Two-rooted Mandibular Premolar: A case report with review of 10 years incidence

Introduction- The root canal morphology of teeth is often extremely complex and highly variable. One such morphological oddity is the presence of two roots, with a reported incidence of 1.8%. Case- A 16-year-old female patient complains of pain in the posterior left mandibular tooth for the past 2 weeks. After clinical, radiographic examination, and vitality testing, we diagnosed the patient with Acute apical periodontitis of tooth #34. It was decided to treat the left mandibular first premolar with two roots endodontically. The patient was reviewed after 1 month, 3 months, 6 months , 1 year and radiographs showed satisfactory healing. Conclusion- This case report details the endodontic management of a sparse case of mandibular first premolar with two roots and two canals, which ended with a favorable outcome due to the satisfactory execution of the preferred constituents.

Comprehensive Analysis of Mandibular First Molar Root and Canal Morphology in Saudi Patients Using Cone Beam Computed Tomography (CBCT).

BACKGROUND The goal of conventional endodontic therapy is to clean the root canal system thoroughly, restore tooth function, and prevent re-infection. Success depends on understanding root canal morphology, resolving apical periodontitis, and using proper techniques. Studies highlight variations in root canal anatomy, with cone-beam computed tomography (CBCT) being crucial for accurate diagnosis despite its high cost and limited availability. MATERIAL AND METHODS This retrospective study reviewed CBCT images of 1820 (907 male, 913 female) patients aged 18 to 78 years. Analysis included 2081 mandibular first molars for variations in root and canal morphology and right- and left-side symmetry. Inter-orifice distance was measured, along with distance from the cementoenamel junction (CEJ) to the level of canal bifurcation. RESULTS In this study, 96.01% of teeth had 2 roots and 3.89% had 3 roots. The percentages of canal configuration were 77.70% for 3 canals, 21.58% for 4 canals, 0.67% for 2 canals, and 0.05% for 1 canal. The inter-orifice distance was 2.07 mm for 2 canals in 1 root and 2.86 mm for 2 canals in separate distal roots. Distance from the CEJ to canal bifurcation varied significantly between 2 canals within 1 distal root (3.35 mm), 2 canals in separate distal roots (1.60 mm), as well as between distal (3.35 mm) and mesial roots (1.10 mm). CONCLUSIONS In mandibular first molars, only 3.89% have additional distolingual roots. Sex and ethnicity showed no influence on number of roots and canals. Distal canals showed a deeper bifurcation and greater inter-orifice distance than did mesial canals.