C-shaped canal configuration in mandibular premolars and molars: prevalence, correlation, and differences: an In Vivo study using cone-beam computed tomography

Aims: To evaluate the prevalence, correlation, and differences of C-shaped canal morphology in mandibular premolars and molars by means of cone-beam computed tomography (CBCT). Materials and Methods: A total of 1433 mandibular premolars and molars CBCT scans from the Saudi population were evaluated. Axial sections of the roots were acquired at coronal, middle, and apical levels to evaluate C-shaped canals types. The prevalence, correlation, differences of C-shaped canals, bilateral/unilateral presence, gender differences, and location of external grooves on roots were assessed. Results: The prevalence of C-shaped canals in the first premolars was 1.5%, 0.80% in second premolars and 7.9% in second molars, whereas C-shaped canals were absent in first molars. No correlation was found between the presence of C-shaped canals within premolars and molars and between the two groups in the same individual. Both premolars and molars exhibited different types of C-shaped canals, C2 being predominant in premolars and C3 in second molars. Longitudinal external grooves were mostly located on mesiolingual (ML) surface in premolars and lingual in molars. Females showed more prevalence of C-shaped canals in second molars and no differences in premolars. Bilateral symmetry and unilateral presence in premolars and second molars were not significant. Conclusions: Although the prevalence of C-shaped canals is significantly higher in mandibular second molars, they are also found in mandibular premolars but in small percentages. No significant differences were found between both genders and both sides. Since they exhibit unpredictable morphology and differences across the root length, the use of small field CBCT is recommended when such anatomy is presented in a tooth indicated for root canal treatment for better management.