ABSTRACT
Introduction:
The study examined mandibular premolars’ root and canal distribution across genders and sides.
Materials and Methods:
Cone-beam computed tomography (CBCT) imaging of mandibular premolars was performed using SINORA ORTHOPHOS XG 3D, with specific parameters set.
Results:
Cone-beam computed tomography (CBCT) imaging of 100 participants revealed mostly single-rooted premolars, with slight variations, notably among females. Mandibular first premolars predominantly had single canals and roots, with a higher occurrence of two canals in females. Statistical analysis showed no significant gender- or side-based differences in root distribution. The findings underscore gender-specific variations in premolar morphology, highlighting the importance of tailored treatment planning, especially for the left side.
Conclusion:
While CBCT proves valuable, further research is needed to optimize its utility in endodontic decision-making.
KEYWORDS: Anatomical variations, cone-beam computed tomography (CBCT), gender differences, root canal morphology
INTRODUCTION
Mandibular premolars are usually characterized as oval-shaped, single-rooted teeth, but little is known about the intricate root canal structure of these teeth, particularly with reference to gender differences among different ethnic groups. The purpose of this study was to compare the root canal morphology of Indian populations’ mandibular premolars in relation to gender.
METHODOLOGY
The study assessed gender-based differences in root canal morphology among 100 participants (50 males and 50 females) aged 15–60 years. Conducted at Vyas Dental College and Hospital in Jodhpur, Rajasthan, a clinico-observational approach was utilized. Cone-beam computed tomography (CBCT) imaging of mandibular premolars was performed using SINORA ORTHOPHOS XG 3D, with specific parameters set. The analysis focused on root and canal numbers from cement-enamel junction to apex, employing Microsoft Excel and SPSS for statistical analysis, including Pearson’s Chi-square test (P < 0.05). The study aimed to determine variations in root and canal anatomy, contributing to enhanced understanding and potentially tailored treatment approaches in Indian populations.
RESULTS
Root canal distribution in mandibular premolars showed comparable patterns for both genders and sides. Table 1 reveals that most males (96%) and females (91%) with mandibular first premolars (MFPs) had single roots, with a minority displaying two roots. While males predominantly had single canals (92%), females exhibited a higher proportion of two canals (20%). Gender-based differences in canal distribution were significant (χ2 = 5.9801, P = 0.014468), while root distribution showed no significance (χ2 = 2.0568, P = 0.151531). In mandibular second premolars (MSPs), primarily single-rooted, females exhibited a higher proportion of two canals (2%), as seen in Table 2. The root canal distribution did not differ significantly across genders (P > 0.05). As seen in Table 3, no discernible variation (P > 0.05) in root canal distribution in MFPs between sides was observed. No discernible difference in root distribution (P > 0.05) was observed [Table 4], albeit a slight variance in canal distribution between MSPs’ sides.
Table 1.
Number and percentage of roots and canals in the mandibular first premolars for the two genders
| No. | Root | Canal | |||
|---|---|---|---|---|---|
|
|
|
||||
| n | % | n | % | ||
| Male | 1 | 96 | 96 | 92 | 92 |
| 2 | 4 | 4 | 8 | 8 | |
| Female | 1 | 91 | 91 | 80 | 80 |
| 2 | 9 | 9 | 20 | 20 | |
| χ 2 | 2.0568 | 5.9801 | |||
| P | 0.151531 | 0.014468 | |||
Table 2.
Number and percentage of roots and canals in the mandibular second premolars for the two genders
| No. | Root | Canal | |||
|---|---|---|---|---|---|
|
|
|
||||
| n | % | n | % | ||
| Male | 1 | 100 | 100 | 100 | 100 |
| 2 | 0 | 0 | 0 | 0 | |
| Female | 1 | 100 | 100 | 98 | 98 |
| 2 | 0 | 0 | 2 | 2 | |
| χ 2 | 0 | 2.02 | |||
| P | 1 | 0.15523914 | |||
Table 3.
Number and percentage of roots and canals in the mandibular first premolars for the two side
| No. | Root | Canal | |||
|---|---|---|---|---|---|
|
|
|
||||
| n | % | n | % | ||
| Left | 1 | 92 | 92 | 82 | 82 |
| 2 | 8 | 8 | 18 | 18 | |
| Right | 1 | 95 | 95 | 90 | 90 |
| 2 | 5 | 5 | 10 | 10 | |
| χ 2 | 0.7404 | 2.6578 | |||
| P | 0.3895 | 0.1030 | |||
Table 4.
Number and percentage of roots and canals in the mandibular second premolars for the two side
| No. | Root | Canal | |||
|---|---|---|---|---|---|
|
|
|
||||
| n | % | n | % | ||
| Left | 1 | 100 | 100 | 98 | 98 |
| 2 | 0 | 0 | 2 | 2 | |
| Right | 1 | 100 | 100 | 100 | 100 |
| 2 | 0 | 0 | 0 | 0 | |
| χ 2 | 0.000 | 2.020 | |||
| P | 1.000 | 0.1552 | |||
DISCUSSION
Variations in root canal morphology in mandibular premolars significantly influenced endodontic treatment outcomes. Understanding these anatomical intricacies, including gender-specific differences, was deemed essential for effective treatment planning. The study contributed to this understanding by examining gender disparities in root canal architecture in mandibular premolars. CBCT has many advantages in different branches of dentistry such as endodontics, TMJ evaluation, oral surgery, and periodontics.[1,2] Previous research, such as that by Cleghorn et al.[3] and Yu et al.[4], laid the groundwork for the investigation, elucidating geographical and ethnic influences on root canal morphology. The findings were consistent with studies like those by Kazemipoor et al.[5] and Lu et al.,[6] which highlighted variations in root canal morphology across different populations. In addition, Serman and Hasselgren[7] emphasized the anatomical diversity of mandibular premolars, supporting the observations. Trope et al.[8] and Sabala et al.[9] underscored the importance of considering racial factors in endodontic care, aligning with the investigation’s emphasis on ethnicity-related variations. The alignment of the results with previous studies in the Turkish population by Sert and Bayirli[10] and Alavi et al.[11] added credibility to the findings. Similarly, the prevalence of solitary canals in mandibular premolars across diverse populations, as noted by Alavi et al.[12] and Kazemipoor et al.,[5] was consistent with the observations. Furthermore, the study identified interesting insights into the root and canal anatomy of mandibular premolars, particularly concerning gender and side differences. Although most premolars exhibited a single root, variations were observed, with a small percentage displaying two roots. Similarly, most premolars had a single canal, with only a small proportion having two canals. Despite these variations, there was a minimal difference in root distribution between the left and right sides, highlighting the complexity of canal distribution. The findings contributed to the broader understanding of root canal morphology, offering insights into gender-specific variations and highlighting the need for personalized treatment planning. The genetic influences on root canal form, as suggested by Hajihassani et al.,[12] further underscored the importance of considering hereditary factors in understanding anatomical variations. Advantages of the study include comprehensive gender and side analysis in mandibular premolar morphology, enriching our understanding of root canal features across populations. However, limitations such as population-specific focus and methodological constraints may restrict generalizability. The lack of longitudinal data hampers insights into treatment outcomes.
CONCLUSION
Gender differences in MFP root canal morphology are crucial, particularly in females’ left side. Although no gender-specific discrepancies in single-rooted premolars are evident, subtle canal distribution variations require precise assessment and personalized treatment planning. A valuable tool for evaluating complex root canal architecture is CBCT. Future studies can enhance clinical usefulness by addressing methodological constraints and racial anatomical features. Overall, the study contributed to our understanding of the anatomy of root canals in mandibular premolars by identifying gender-specific variations and providing guidance for treatment planning. More thorough research involving a range of populations is required.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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