Cone-beam computed tomography evaluation of canal morphology of maxillary premolars in Malaysian subpopulation using two canals classification

Aim: This study used cone‑beam computed tomography (CBCT) to describe the maxillary first premolar anatomy in Malaysian subpopulation using two classification systems by Vertucci (1984) and Ahmed et al. (2017).
Methods: A total of 200 CBCT images involving 282 first maxillary premolar teeth were obtained from the Oral Radiology Unit, Faculty of Dentistry, University Sains Islam Malaysia. The number of roots and canal configuration for each tooth were described using the classification system established by Vertucci (1984) and Ahmed et al. (2017). Correlation among sex, ethnicity, and tooth positioning was determined using Chi‑squared test (P = 0.05).
Results: One root was present in 64.2% of maxillary first premolars and was predominant in both males and females. The majority of Malay and Chinese had one root at 60% (n = 123) and 81.8% (n = 54), respectively, whereas Indian showed two roots at 63.6% (n = 11, P < 0.05). The number of roots and canals did not differ significantly between the right and left first maxillary premolars in both classifications. Vertucci’s Type IV configuration was the most common, with significant differences observed in the Malays and Indian population, but no significant variations across ethnicities. The classification proposed by Ahmed et al. identified the 2 FPB1 P1 configuration as the predominant morphology, particularly among the Malay (35.1%, n = 72) and Indian (63.6%, n = 7/11) groups with notable gender disparities. The 1 FP1‑2 was frequently observed in the Chinese population (24.2%, n: 16). Significant differences in the distribution of canal configurations were found among the ethnicities in the Ahmed classification.
Conclusion: A variety of root and canal anatomical presentation were observed in this subpopulation. Classification systems sufficiently describe maxillary first premolar anatomy. Nonetheless, the classification system proposed by Ahmed et al. provides a precise description of complex anatomical canal configuration in teeth with multiple root and root canals.