Cone beam computed tomography evaluation of root canal morphology of maxillary premolars in North-West sub-population of Pakistan

Main Article Content

Shahzad Ali Shah


OBJECTIVES: To determine the number and configuration of canals in permanent maxillary premolars using Cone Beam Computed Tomography (CBCT) and the relationship between canals count and patient gender in northwest region of Pakistan.

METHODS: This cross-sectional observational study was conducted at Khyber College of Dentistry (KCD) Peshawar, Pakistan. Data was collected from July 1st to 30th December 2020, using 133 patient’s CBCT scans with 266 maxillary premolar teeth. Roots and canals frequency as well as configurations were analyzed using Vertucci canal classification. CBCT images were obtained from Radiology department of KCD. Data were analyzed using SPSS-23 software,

RESULTS: Type-I Vertucci's canal composition was most common in first premolars (45.4%), followed by Type-IV (25.9%). Type-I was the most frequent find in second premolars (64.2%), followed by Type-III (15.4%). In Maxillary first premolars, 247 (92.8%) were single-rooted and 19 (7.14%) were two-rooted. In maxillary second premolars, 155 (57.9%) were single-rooted, 110 (41.3%) were two-rooted, and one (0.37%) was three-rooted.  In first & second premolar, single-root was the commonest root among males (92.7% & 58.4%) and females (30.8% and 19%) respectively. Gender-based difference in canal count in all premolars was not-significant. Mean tooth length of first and second premolar was 19.40±2.035 mm and 20.08±2.395 mm respectively. Mean crown length of first and second premolar was 6.05±0.752 mm and 5.69±0.505 mm respectively. 

CONCLUSION: Most of the maxillary first and second premolars had Vertucci classification Type-I configuration. Gender-based diversity for number of canals was not-significant. All Vertucci canal configuration types were observed in maxillary premolars.

Article Details

How to Cite
Shah, S. A. “Cone Beam Computed Tomography Evaluation of Root Canal Morphology of Maxillary Premolars in North-West Sub-Population of Pakistan”. KHYBER MEDICAL UNIVERSITY JOURNAL, vol. 15, no. 2, June 2023, pp. 116-21, doi:10.35845/kmuj.2023.23168.
Original Articles


Senan EM, Alhadainy HA, Genaid TM, Madfa AA. Root form and canal morphology of maxillary first premolars of a Yemeni population. BMC Oral Health 2018;18(1):94.

Przesmycka A, Jędrychowska-Dańska K, Masłowska A, Witas H, Regulski P, Tomczyk J. Root and root canal diversity in human permanent maxillary first premolars and upper/lower first molars from a 14th–17th and 18th–19th century random population. Arch Oral Biol 2020;110:104603.

Mahmood TR. Management of apical periodontitis using wave one gold reciprocating files, single-cone endodontic approach: A case series. Ann Med Surg (Lond) 2021;66:102385.

Almazrou YM, Edrees FA, Alaqeel S, Alqahtani F, Albihlal A. Root canal treatment of maxillary second premolar with two roots and three canals: Two case reports. Saudi Endod J 2020;10(3):274-8.

Maghfuri S, Keylani H, Chohan H, Dakkam S, Atiah A, Mashyakhy M. Evaluation of root canal morphology of maxillary first premolars by cone beam computed tomography in Saudi Arabian southern region subpopulation: An in vitro study. Int J Dent 2019;2019:1-6.

Augusti D, Augusti G. Unexpected complication ten years after initial treatment: Long-term report and fate of a maxillary premolar rehabilitation. Case Rep Dent 2018;2018:3287965 .

Saber SEDM, Ahmed MHM, Obeid M, Ahmed HMA. Root and canal morphology of maxillary premolar teeth in an Egyptian subpopulation using two classification systems: A cone beam computed tomography study. Int Endod J 2019;52(3):267-278.

Alnassar FA, Almutairi W, Al-Dahman Y. Radiographic variations of maxillary and mandibular premolars with type V canal configuration – A cone-beam computed tomographic study. Saudi Endod J 2021;11(3):345-9.

Yan Y, Li J, Zhu H, Liu J, Ren J, Zou L. CBCT evaluation of root canal morphology and anatomical relationship of root of maxillary second premolar to maxillary sinus in a western Chinese population. BMC Oral Health 2021;21(1):358.

Matus D, Fuentes R, Navarro P, Betancourt P. Morphological analysis of maxillary first premolars by cone beam computed tomography in a Chilean sub-population. Int J Morph 2020;38(5):1266-70.

Eskoz N, Weine FS. Canal configuration of the mesiobuccal root of the maxillary second molar. J Endod 1995;21(1):38-42.

Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984;58(5):589-99.

Gulabivala K, Aung TH, Alavi A, Ng YL. Root, and canal morphology of Burmese mandibular molars. Int Endod J 2001;34(5):359-70.

Aps JKM, Lim LZ, Tong HJ, Kalia B, Chou AM. Diagnostic efficacy of and indications for intraoral radiographs in pediatric dentistry: A systematic review. Eur Arch Paediatr Dent 2020;21(4):429-62.

Borghesi A, Michelini S, Zigliani A, Tonni I, Maroldi R. Three-rooted maxillary first premolars incidentally detected on cone beam CT: An in vivo study. Surg Radiol Anat 2019;41(4):461-8.

Olczak K, Pawlicka H, Szymański W. Root form and canal anatomy of maxillary first premolars: A cone-beam computed tomography study. Odontology 2021;110(2):365–75.

Shahzad AS. Endodontic management of mandibular second premolar with vertucci root canal configuration type V. Case Rep Dent 2022;2022:3197393.

Vertucci FJ, Gegauff A. Root canal morphology of the maxillary first premolar. J Am Dent Assoc 1979;99(2):194-8.

Pécora JD, Saquy PC, Neto MDS, Woelfel JB. Root form and canal anatomy of maxillary first premolars. Braz Dent J 1992; 2(2): 87-94.

Wang J, Rousso C, Christensen BI, Li P, Kau CH, MacDoughall M, et al. Ethnic differences in the root to crown ratios of the permanent dentition. Orthod Craniofac Res 2019;22(2):99-104.

Shahid F, Alam MK, Khamis MF. Maxillary and mandibular anterior crown width/height ratio and its relation to various arch perimeters, arch length, and arch width groups. Eur J Dent 2015;9(4):490-9.

Celikten B, Orhan K, Aksoy U, Tufenkci P, Kalender A, Basmaci F, et al. Cone-beam CT evaluation of root canal morphology of maxillary and mandibular premolars in a turkish cypriot population. BDJ Open 2016;2(1):15006.

Monsarrat P, Arcaute B, Ove AP, Maury E, Telmon M, Georgelin -Gurgel M, et al. Interrelationships in the variability of root canal anatomy among the permanent teeth: A full-mouth approach by cone-beam CT. PLoS One 2016;11(10):e0165329.

Bulut DG, Kose E, Ozcan G, Sekerci AE, Canger EM, Sisman Y. Evaluation of root morphology and root canal configuration of premolars in the Turkish individuals using cone beam computed tomography. Euro J Dent 2015; 9(4): 551-7.

Alqedairi A, Alfawaz H, Al-Dahman Y, Alnassar F, Al-Jebaly A, Alsubait S. Cone-beam computed tomographic evaluation of root canal morphology of maxillary premolars in a Saudi population. Biomed Res Int 2018;2018:

Ahmed HMA, Musale PK, El Shahawy OI, Dummer PMH. Application of a new system for classifying tooth, root and canal morphology in the primary dentition. Int Endod J 2020;53(1):27-35.

Sadaf A, Huma Z, Javed S, Masood A. Maxillary premolar teeth: Root and canal stereoscopy. Khyber Med Univ J 2019;11(4):240-7.