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Comparative performance of the ahmed and vertucci systems in classifying mandibular premolar canal morphology: a Bayesian and information-theoretic analysis

Fatma Pertek HatipoğluDepartment of Endodontics, Recep Tayyip Erdogan University, Rize, TurkeyGüldane MağatDepartment of Oral Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, TurkeyMohmed Isaqali KarobariDepartment of Conservative Dentistry and Endodontics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospital, Saveetha University, Chennai, Tamil Nadu, 600077, India. [email protected]Glynn Dale BuchananDepartment of Endodontics, School of Dentistry, Faculty of Medicine and Health, University of Sydney, Sydney, AustraliaIndira TulegenovaSchool of Dentistry, Kazakh National Medical University, , Almaty, KazakhstanNessrin TahaDepartment of Conservative Dentistry, Jordan University of Science and Technology, Irbid, JordanRafael Fernández‐GrisalesDepartment of Endodontics, School of Dentistry, CES University, Medellín, ColombiaO.E. BekjanovaDepartment of Faculty Therapeutic Dentistry, Tashkent State Medical University., Tashkent, UzbekistanMehdi RahimiSydney Dental HospitalDavid DonnermeyerDepartment of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, SwitzerlandAhmed A. MadfaDepartment of Conservative Dentistry, Faculty of Dentistry, Thamar University, Dhamar, YemenXenos PetridisDepartment of Endodontics, Section of Dental Pathology and Therapeutics, School of Dentistry, National and Kapodistrian University of Athens, Athens, GreeceMartha Gallegos IntriagoEndodontic Department of Dentistry, Universidad Central del Ecuador Quito, Quito, EcuadorSurendar SugumaranDepartment of Cariology and Comprehensive Care Dentistry, NYU College of Dentistry, New York, USASafaa AllawiDepartment of Endodontic and Operative Dentistry, Faculty of Dentistry, Damascus University, Damascus, SyriaAnja IvicaUniversity of Zagreb School of Dental Medicine, Zagreb, CroatiaWen Yi LimDepartment of Restorative Dentistry, National Dental Centre, Singapore, SingaporeAbdelrahman HamoudaDepartment of Endodontic, Faculty of Dentistry, Al-Azhar University, Cairo, EgyptRohan JagtapDivision of Oral and Maxillofacial Radiology, Department of Care Planning and Restorative Sciences,, University of Mississippi Medical Center School of Dentistry, Jackson, USAAnna LehmannDepartment of Conservative Dentisty and Endodontics, Poznan University of Medical Sciences, Poznan, PolandJosé Martín‐CrucesEndodontics and Restorative Dentistry Unit, School of Medicine and Dentistry, Universidade de Santiago de Compostela, A Coruña, SpainPaulo PalmaCenter for Innovation and Research in Oral Sciences (CIROS), Faculty of Medicine, University of Coimbra, Coimbra, PortugalÖmer HatipoğluDepartment of Restorative Dentistry, Recep Tayyip Erdogan University, Rize, Turkey

2026en

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Litsenziya: cc-by-nc-nd

ABI

Annotatsiya

This multinational cone-beam computed tomography (CBCT) study evaluated the root canal morphology of mandibular first premolars (M1Ps) from 21 countries and compared how well the Ahmed and Vertucci classification systems represented these patterns. A total of bilateral mandibular first premolars from eligible CBCT scans were assessed using both systems, and the data were analyzed with a hierarchical probabilistic approach to account for population and imaging-related variation. Across the overall dataset, a simple single-canal configuration was the dominant pattern, and this remained the most common finding in all populations despite limited but structured variation in less frequent subclasses. The Ahmed system classified all observed configurations, whereas the Vertucci system left approximately 10.2% of cases without an equivalent category. In addition, Ahmed preserved more anatomical detail, while Vertucci compressed several distinct configurations into broader groups. Demographic and imaging-related factors had modest effects, with voxel size showing the clearest technical influence on the detection of more complex patterns. Overall, M1P morphology showed a stable global pattern with secondary heterogeneity, and the Ahmed system provided a more complete and informative representation for CBCT-based morphology assessment across diverse populations.

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DOI: 10.1038/s41598-026-52409-7

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