Evaluation of Root Canal Morphology of Maxillary First and Second Premolars by Cone-Beam Computed Tomography in Saudi Population

Objectives: To estimate the prevalence of different root canal morphological variants in maxillary first and second premolars, and to analyze differences across gender and nationality in western Saudi Arabia individuals using conebeam computed tomography (CBCT) who presented for dental care during February 2021- April 2021. Methods: Maxillary first and second premolars were analyzed independently to determine the number of roots and canal configuration using Vertucci's classification. The distribution by gender and nationality was analyzed using Fisher's exact test with Monte Carlo simulation. Inter-examiner and intra-examiner reliability were evaluated using Cohen's kappa coefficient (1.0; P<0.001 and 0.9; P<0.001, respectively). Results: Maxillary first premolars were double-rooted in 57.8% and type IV was the most frequent (63.6%), followed by type II (18.3%). Second premolars were single-rooted in 77.6%, with type I being the most frequent (37.8%) in females (48.2%); while type IV being most frequent in males (33.8%). In both first and second premolars, females had a significant predilection to single root pattern. Differences across nationality were statistically significant with respect to canal configuration of maxillary first premolars. Conclusion: There is a high heterogeneity in the maxillary premolar root canal configuration among the studied Saudi population, with significant gender disparities supporting fewer roots and canals in females.