Prevalence of C-shape Canal in Second Mandibular Premolars: A Systematic Review and Meta-analysis
Tulegenova I. Omarova B.A. Kopbayeva M. Altynbekov K. Kuanyshbekov Y. Karibayeva I.
1 April 2025Wolters Kluwer Medknow Publications
Indian Journal of Dental Research
2025#36Issue 2228 - 235 pp.
Objectives: C-shaped root canal morphology presents significant challenges in endodontic treatment due to its complex anatomy. This systematic review and meta-analysis evaluated the prevalence of C-shaped canal anatomy in mandibular second premolars and examined the influence of geographic variation on prevalence rates. Materials and Methods: The study followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematically searching five electronic databases: PubMed, Web of Science, ScienceDirect, Scopus, and Google Scholar. Eligible studies included cross-sectional, prospective, and observational studies on C-shaped canal prevalence in adult mandibular second premolars. Statistical Analysis: A random-effects model in RStudio software was used to calculate the pooled prevalence and 95% confidence intervals (CI) of C-shaped canals. Results: The pooled prevalence based on participants was 1.31% (CI: 0.68–2.53; I² = 90%; P < 0.01). Based on the number of teeth, the prevalence was 0.96% (CI: 0.46–2.00; I² = 93%; P < 0.01), also with high heterogeneity. Geographic analysis showed the highest prevalence in South America 5.83% (CI: 0.57–40.04; I² = 95%; P < 0.01) and the lowest in Australia 0.42% (CI: 0.31–0.93). Conclusions: The study demonstrated variability in the prevalence of C-shaped canals, with a pooled estimate of 1.31% based on participant-level data and 0.96% based on tooth-level assessment. The substantial heterogeneity observed across studies highlights the morphological diversity of root canal systems. Geographic differences were observed, with the highest prevalence in South America and the lowest in Australia. These findings underscore the importance of region-specific diagnostic vigilance.
C-shape , mandibular second premolars , meta-analysis , prevalence , root canal , systematic review
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Department of Prosthetic Dentistry, Kazakh National Medical University Named After S.D. Asfendiyarov, Almaty, Kazakhstan
Department of Therapeutic Dentistry, Kazakh National Medical University Named After S.D. Asfendiyarov, Almaty, Kazakhstan
Department of Orthodontic Dentistry, Kazakh National Medical University Named After S.D. Asfendiyarov, Almaty, Kazakhstan
Department of Spinal Neurosurgery and Peripheral, Nervous System Pathology, National Center for Neurosurgery, Astana, Kazakhstan
Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, United States
Department of Prosthetic Dentistry
Department of Therapeutic Dentistry
Department of Orthodontic Dentistry
Department of Spinal Neurosurgery and Peripheral
Department of Health Policy and Community Health
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