Alsayed Tolibah Yasser, Al-Shiekh Mohammed N, Abbara Mohammad Tamer, Alhaji Marwan, Aljabban Osama, Bshara Nada
Department of pediatric dentistry, Damascus University, P.O. Box 3062, Damascus,, Syria.
Department of Endodontics, Damascus University, P.O. Box 3062 Dr, Damascus, Syria.
BMC Oral Health. 2025 Sep 26;25(1):1460. doi: 10.1186/s12903-025-06838-x.
This study aimed to assess the root number, length, and root canal morphology of extracted mandibular premolars (MPs) from adolescents in Damascus using two classification systems: Vertucci's classification and Ahmed's classification. This was conducted through radiographic examination utilizing Cone Beam Computed Tomography (CBCT) and digital dental radiography analysis. Additionally, the study sought to investigate the correlation between these variables and gender within the sample.
Immediately after extraction, the root number and maximum length were recorded. Each MP was then radiographed in buccolingual and mesiodistal directions using digital periapical radiographs. Subsequently, MPs were scanned using a CBCT device (200 μm voxel size) and the root canal morphology was classified based on Vertucci's classification and Ahmad's classification based on both radiographs. Moreover, the presence of C-shaped canals was investigated and classified according to the Fan et al. classification. Finally, the previous findings were correlated with the patient's gender, and statistical analysis was performed using the Chi-Square test and T-test in the SPSS program. The confidence interval used for the Chi-square test was 95%. Moreover, the sensitivity, accuracy, specificity, and overall agreement tests was performed to compare digital sensor radiographs with the gold standard CBCT radiographs.
The sample included 255 first MPs and 163 s MPs. No significant differences were found between males and females regarding the frequency of one, two, or three roots in the first and second MPs (p = 0.931 and p = 0.010, respectively). Most MPs had a single root. The mean length of the first MP was 21.9 mm, and the second MP was 21 mm, with males generally having longer MPs than females (p < 0.001). There were no significant gender differences in the distribution of first and second MPs according to Vertucci and Ahmed classifications (p > 0.05). Type I (TN) was the most common root canal morphology, followed by Type V (TN). Low occurrence of C-shape canals was observed in first and second MPs (4.31% and 9.82%, respectively). The sensitivity, specificity, accuracy, and overall agreement between the two radiographic assessment techniques of both MPs were highly comparable.
It can be concluded that variations in root number and canal classifications are evident in MPs. Although gender does not influence the root number or canal morphology, males tend to have longer MPs. Moreover, it is noteworthy that digital sensors performed better in detecting small accessory canals in the apical third.
本研究旨在使用两种分类系统——韦尔图奇分类法和艾哈迈德分类法，评估来自大马士革青少年的拔除下颌前磨牙（MPs）的牙根数量、长度和根管形态。这是通过使用锥形束计算机断层扫描（CBCT）和数字牙科X线摄影分析进行影像学检查来实现的。此外，该研究还试图调查样本中这些变量与性别的相关性。
拔牙后立即记录牙根数量和最大长度。然后使用数字根尖片在颊舌向和近远中向对每个MP进行X线摄影。随后，使用CBCT设备（体素大小为200μm）对MP进行扫描，并根据韦尔图奇分类法和基于两种X线片的艾哈迈德分类法对根管形态进行分类。此外，还根据范氏等的分类法对C形根管的存在情况进行了调查和分类。最后，将先前的研究结果与患者性别进行相关性分析，并在SPSS程序中使用卡方检验和T检验进行统计分析。卡方检验使用的置信区间为95%。此外，还进行了敏感性、准确性、特异性和总体一致性测试，以比较数字传感器X线片与金标准CBCT X线片。
样本包括255颗第一前磨牙和163颗第二前磨牙。在第一前磨牙和第二前磨牙中，单根、双根或三根的频率在男性和女性之间未发现显著差异（分别为p = 0.931和p = 0.010）。大多数MPs为单根。第一前磨牙的平均长度为21.9mm，第二前磨牙为21mm，男性的MPs通常比女性的长（p < 0.001）。根据韦尔图奇分类法和艾哈迈德分类法，第一前磨牙和第二前磨牙的分布在性别上无显著差异（p > 0.05）。I型（TN）是最常见的根管形态，其次是V型（TN）。在第一前磨牙和第二前磨牙中观察到C形根管的发生率较低（分别为4.31%和9.82%）。两种MPs的两种影像学评估技术之间的敏感性、特异性、准确性和总体一致性具有高度可比性。
可以得出结论，MPs在牙根数量和根管分类上存在明显差异。虽然性别不影响牙根数量或根管形态，但男性的MPs往往更长。此外，值得注意的是，数字传感器在检测根尖三分之一处的小副根管方面表现更好。
