Empirical Study of Root Morphology and Canal Configuration of Mandibular First Molars in Patients from the North West Zone Using CBCT

Cone beam computed tomography has transformed endodontic pre-treatment planning, and characterising the root morphology and canal configuration of mandibular first molars in North West Nigerian patients fills an important anatomical reference gap for endodontic practice. This study empirically characterised the root morphology and canal configuration of mandibular first molars in 200 patients attending Aminu Kano Teaching Hospital, Kano, using CBCT images obtained for clinical purposes with patient consent. Roots were classified by number and canal configuration analysed using Vertucci's classification. Demographic data were correlated with morphological findings. Results showed that two-rooted mandibular first molars were present in 78.5 percent of cases. Three-rooted mandibular first molars (radix entomolaris) were identified in 12.5 percent, notably higher than reported in European populations. Vertucci Type IV (two separate canals throughout) was the most common mesial root configuration (58.3 percent). Isthmus connections between mesial canals were identified in 72.1 percent. Accessory canals were identified in 22.4 percent of distal roots. No significant age or sex differences in canal configuration were observed, but there was a trend toward higher radix entomolaris frequency in females. The study provides clinically valuable morphological reference data for endodontists treating North West Nigerian patients and recommends routine CBCT pre-treatment planning for mandibular molars with atypical periapical presentations, and updates to the dental school endodontics curriculum to reflect local anatomical variation.

Keywords: root canal morphology, CBCT, mandibular first molar, Vertucci classification, North West Nigeria