A comprehensive analysis and sex-related differences in root and root canal anatomy in the Taiwanese population

Authors

• Ho-Sheng Chiang, Department of Operative Dentistry and Endodontics, College of Oral Medicine, Tri-Service General Hospital and National Defense Medical University, Taipei, Taiwan
• Wei-Cheng Lee, Department of Orthodontics and Dentofacial Orthopedics, College of Oral Medicine, Tri-Service General Hospital and National Defense Medical University, Taipei, Taiwan
• Ying-Wu Chen, Department of Periodontology, College of Oral Medicine, Tri-Service General Hospital and National Defense Medical University, Taipei, Taiwan
• Ling-Yu Kung, Department of Family Dentistry and Oral Diagnosis, College of Oral Medicine, Tri-Service General Hospital and National Defense Medical University, Taipei, Taiwan
• Kuei-Yuan Chen, Department of Oral and Maxillofacial Surgery, College of Oral Medicine, Tri-Service General Hospital and National Defense Medical University, Taipei, Taiwan
• Ren-Yeong Huang, Department of Periodontology, College of Oral Medicine, Tri-Service General Hospital and National Defense Medical University, Taipei, Taiwan
• Yi-Shing Shieh, Department of Operative Dentistry and Endodontics, College of Oral Medicine, Tri-Service General Hospital and National Defense Medical University, Taipei, Taiwan
• Yu-Chiao Wu, Department of Operative Dentistry and Endodontics, College of Oral Medicine, Tri-Service General Hospital and National Defense Medical University, Taipei, TaiwanFollow

First Page

1520

Last Page

1530

Abstract

Background/purpose: Root canal morphology exhibits substantial anatomical variation influenced by ethnicity and sex, which may complicate endodontic treatment if unrecognized. This study aimed to comprehensively evaluate root and root canal configurations in a Taiwanese population using cone-beam computed tomography (CBCT) and to investigate sex-related differences in canal anatomy.

Materials and methods: CBCT scans from 802 patients treated between 2022 and 2024 were retrospectively analyzed. A total of 18,578 teeth met the inclusion criteria. Root canal configurations were assessed for every root using Vertucci’s classification, and C-shaped canals were further categorized based on morphology. Sex-related differences were analyzed using chi-square tests.

Results: Complex canal configurations were frequently observed, particularly in molars. Distolingual roots were identified in 20.7% of mandibular first molars, and C-shaped canal configurations were present in 44.0% of mandibular second molars. Males exhibited a significantly higher prevalence of complex canals, including second mesiobuccal canals in maxillary molars and complex configurations in mandibular first premolars (P < 0.05). In contrast, C-shaped canals were significantly more prevalent in females (P < 0.05). No significant sex-related difference was observed in the prevalence of distolingual roots.

Conclusion: This study presents the first large-scale CBCT-based dataset of root and root canal morphology in an East Asian population, providing a comprehensive reference for Taiwanese individuals. Analysis of more than 1,000 molars in each group demonstrated substantial anatomical variability and significant sex-related differences, underscoring the importance of population- and sex-specific morphological datasets.

Recommended Citation

Chiang, Ho-Sheng; Lee, Wei-Cheng; Chen, Ying-Wu; Kung, Ling-Yu; Chen, Kuei-Yuan; Huang, Ren-Yeong; Shieh, Yi-Shing; and Wu, Yu-Chiao (2026) "A comprehensive analysis and sex-related differences in root and root canal anatomy in the Taiwanese population," Journal of Dental Sciences: Vol. 21: Iss. 3, Article 20.
Available at: https://jds.ads.org.tw/journal/vol21/iss3/20

Publication Date

2026