Cone-beam computed tomography analysis of maxillary premolar canal anatomy: Ahmed’s versus Vertucci’s classifications in a Jordanian cohort

Objectives: This study analyzed the root and canal configurations of maxillary premolars in a Jordanian subpopulation using cone-beam computed tomography (CBCT) and classified them based on Vertucci’s and Ahmed’s systems.Methods: Two hundred CBCT scans of 800 maxillary premolars were retrospectively assessed for root morphology, canal configurations, and root canal divergence and merging. Data was statistically analyzed.Results: The study included 70 males and 130 females. Most right and left maxillary first premolars (RFPM, LFPM) had two roots (59.0% and 58.5%), with a significant association between sex and root number for RFPM and LFPM (p < 0.05). In contrast, the right and left maxillary second premolars (RSPM, LSPM) mostly had a single root (87.5% and 88.5%), with no association with sex. Vertucci’s classification showed type IV as the predominant configuration in first premolars (RFPM, 65.0% and LFPM, 67.0%) and type I in second premolars (RSPM, 44.0% and LSPM, 49.0%). A significant sex association was found only with RSPM. Ahmed’s classification revealed that maxillary premolar with two separated roots and two separated canals (²MP B¹ P¹) was mostly found in first premolars (RFPM, 58.0% and LFPM, 56.0%), and maxillary premolar with one root and one canal (¹MP¹) in second premolars (RSPM, 44.0% and LSPM, 49.0%), with a significant sex association for RSPM and LSPM (p < 0.05). Age had no impact, and symmetry was observed between the right and left sides. Three-rooted premolars were identified in four cases. Almost all of Vertucci’s types and numerous codes from Ahmed’s classification were documented.Conclusions: CBCT revealed diverse anatomical variations in the Jordanian subpopulation, with Ahmed’s classification providing more detailed canal configurations than Vertucci’s, uncovering previously overlooked variations.