Iranian Endodontic Journal

Abstract

Introduction: This study assessed the configuration of second mesiobuccal canals (MB2) of maxillary first molars according to Vertucci’s classification in an Iranian population using high-resolution cone-beam computed tomography (CBCT). Materials and Methods: This cross-sectional study evaluated 385 high-resolution CBCTs of maxillary first molars with three roots (276 females, 109 males). The scans were taken with 110 kVp, 12 mA, 5×5 mm field of view (FOV), and 100 µm (0.1 mm) voxel size. The configuration of MB2 was classified by Vertucci’s classification. The relationship of canal types with gender and age group (20‑40 and 41‑59 years) was analyzed using Fisher’s exact test with Monte Carlo simulation. Results: The intra‑examiner agreement was excellent (κ=0.91), and inter‑examiner agreement for complex configurations was substantial (κ=0.85). Type IV had the highest frequency (38.2%), followed by type II (22.3%), type VI (14%), type I (10.1%), type III (6.5%), type VII (4.4%), type VIII (2.9%), and type V (1.6%). The frequency of different types significantly varied between males and females (P=0.002) but was not significantly different between the two age groups (P>0.05). Conclusion: In this population, 61.1% of MB2 canals had type IV or higher. Although a significant gender-related association was observed for some configurations, this finding requires cautious interpretation due to the imbalanced sex distributions. High‑resolution CBCT is useful in cases with suspected complex anatomy, but should be applied regarding as low as reasonably achievable (ALARA) principle.