Association between Diabetes Mellitus and Periodontal Diseases: A Survey of the Opinions of Dental Professionals.

OBJECTIVE: This cross-sectional survey aimed to assess the knowledge of dentists and dental assistants practicing in Saudi Arabia regarding diabetes mellitus (DM) and periodontal diseases. SUBJECTS AND METHODS: We used a pretested, closed-ended, multiple-choice questionnaire covering 2 principal sections: the assessment of previous educational training and practice, and the knowledge and scientific background regarding DM and periodontal diseases. The responses were grouped using the Likert-type scale. RESULTS: The questionnaire showed a high reliability value of 0.805 as determined by a Cronbach's α. Out of 365 subjects who were initially interviewed, 239 subjects participated (response rate 65.5%): general dentists (45.6%) and dental hygienists and assistants (54.4%). Of the participating dentists, 70.4% were males; in contrast, 87.7% of dental assistants were female. Eighty-five percent of the participants strongly agreed that evidence supports the association between periodontal diseases and DM. Remarkably, dental assistants (78%) agreed more than dentists (68.5%) that diabetic patients with periodontal conditions would have worse glycemic control compared to diabetic patients with no periodontal diseases. Seventy-five percent of the respondents were confident about performing oral health screening for diabetic patients. Significantly more dental assistants showed their desire to expand their practice to include oral health screening (85%) and education compared to dentists (74%). CONCLUSIONS: Both dentists and dental assistants in Saudi Arabia revealed a satisfactory knowledge level regarding the periodontal disease-diabetes interactions with no significant difference between the two groups. Further studies are recommended to assess the attitude of dental care providers while dealing with diabetic patients.

Marginal and internal fit of CAD/CAM fiber post and cores.

AIM: To evaluate the marginal adaptation and internal fit of milled fiber post and cores using different scanning methods. MATERIALS AND METHODS: Thirty typodont tooth models (Nissin) with pulp cavity were endodontically treated and prepared to receive 30 fabricated fiber post and cores. Three different methods of scanning were used (n = 10): an intraoral scanner (IOS) (Trios 3; 3Shape) to directly digitalize the post space (Group T) and a laboratory scanner to indirectly digitalize the resin pattern (Group RP) and the silicone impression (Group S) of the post space. All the specimens were examined using an optical microscope for the measurement of the vertical marginal discrepancy (VMD), and five in each group were scanned using microcomputed tomography (µCT) for the assessment of the VMD, the internal fit at the corner (IFC), post apex (PA), and at four horizontal cross-sections (CS1-4) inside the canal. All data were analyzed using mixed-design ANOVA, followed by pairwise testing to identify the differences (α = 0.05). RESULTS: Statistical analysis revealed that Group T was associated with the smallest cement space compared with Group RP (P = 0.001) and Group S (P < 0.001) for VMD using µCT or direct microscopy (OM) (P < 0.001). Similarly, the cement space for Group T was smaller than that of Group S (P = 0.039) when measured at the IFC (µCT), and smaller than Group RP (P = 0.025) when measured at CS1-4 (µCT), with CS1 larger than CS3 (P = 0.015). There was no significant difference at PA (P = 0.271). CONCLUSION: Better adaptation was achieved with a complete digital workflow. Scanning the resin pattern or the silicone impression introduced more variables in the digital process or milling of a one-piece fiber post and core.

Shaping Ability of HyFlex EDM and ProTaper Next Rotary Instruments in Curved Root Canals: A Micro-CT Study.

AIM: The aim of this study is to evaluate and compare the shaping ability of HyFlex™ EDM (HFEDM) and ProTaper Next (PTN) rotary instruments in curved root canals by using micro-computed tomography (micro-CT) imaging. MATERIALS AND METHODS: A total of 22 mandibular molar teeth having separate mesial canals with 20 to 30° curvatures were randomly divided into two groups and instrumented with HFEDM (OneFile) or PTN (X1 and X2). Pre- and post-instrumentation micro-CT scans were obtained. Mesiodistal canal transportation and centering ability were evaluated in four cross-sections (2, 4, 6, and 8 mm from apex). Changes in canal volume and surface area were measured for a 10-mm standardized area of interest. Kolmogorov-Smirnov and Shapiro-Wilk tests were used to assess the normality and homogeneity. Independent and paired t tests and one-way ANOVA were used to analyze data at the p < 0.05 level. RESULTS: Compared to PTN, HFEDM showed significantly less mesiodistal canal transportation and improved centering ability in cross-section L6 (p < 0.05). The instruments showed similar increases in volume and surface area of the canals, with minor insignificant differences. CONCLUSION: HFEDM and PTN files were safe to use in curved canals and showed similar shaping ability, while respecting the original anatomies. HFEDM OneFile performed better at the vicinity of the danger zone in terms of mesiodistal canal transportation and centering ability.

Push-Out Bond Strength and Surface Microhardness of Calcium Silicate-Based Biomaterials: An in vitro Study.

OBJECTIVE: This was an in vitro evaluation of push-out bond strength and surface microhardness of calcium silicate-based biomaterials in coronal and apical root dentin. MATERIALS AND METHODS: Ninety sections (2 mm thick) of coronal and apical root dentin were obtained from roots of 60 extracted teeth; the canals were enlarged to a standardized cavity diameter of 1.3 mm. Sections were randomly divided into 6 groups (n = 15 per group), and cavities were filled with Biodentine™, BioAggregate, or ProRoot mineral trioxide aggregate (MTA), according to the manufacturers' instructions. Push-out bond strength values were measured using a universal testing machine under a compressive load at a speed of 1 mm/min. Samples were analyzed under a light microscope to determine the nature of bond failure. Ten samples (2 mm thick) were prepared for all the materials, and Vickers microhardness was determined using a digital hardness tester. Data were analyzed using one-way analysis of variance and Tukey-Kramer multiple comparison tests at a significance level of p < 0.05. RESULTS: Biodentine (42.02; 39.35 MPa) and ProRoot MTA (21.86; 34.13 MPa) showed significantly higher bond strengths than BioAggregate (6.63; 10.09 MPa) in coronal and apical root dentin, respectively (p < 0.05). Biodentine also differed significantly from ProRoot MTA in coronal dentin. Bond failure was predominantly adhesive in Biodentine and ProRoot MTA, while BioAggregate showed predominantly mixed failure. ProRoot MTA (158.52 HV) showed significantly higher microhardness and BioAggregate (68.79 HV) showed the lowest hardness. CONCLUSION: Biodentine and ProRoot MTA showed higher bond strength and microhardness compared to BioAggregate.

A Micro-Computed Tomography Study of the Root Canal Morphology of Mandibular First Premolars in an Emirati Population.

OBJECTIVE: To investigate variations in the root canal morphology of mandibular first premolars in a population from the United Arab Emirates using micro-computed tomography (micro-CT) and conventional radiography. MATERIALS AND METHODS: Three-dimensional images of 50 extracted human mandibular first premolars were produced using a micro-CT scanner, and conventional radiography was also used to record the number of roots, the root canal system configuration, the presence of a C-shaped canal system and lateral canals, intercanal communications, and the number and location of apical foramina. The interpretations of micro-CT and conventional radiography were statistically analyzed using Fisher's exact test. RESULTS: Variable root canal configurations based on Vertucci's classification were observed in the teeth (i.e., types I, III, IV, V, and VII). The examined teeth exhibited the following 2 additional root canal configurations, which did not fit Vertucci's classification: type 1-2-3 and type 1-3. A C-shaped canal configuration was present in 14 (28%) cases, and lateral canals were present in 22 (44%) cases. Apical deltas were found in 25 (50%) cases, intercanal communications were seen in 6 (12%) cases, and apical loops were seen in 2 (4%) of the samples. Micro-CT and X-ray imaging identified 39 (78%) and 34 (68%) apical foramina, respectively. A single apical foramen was detected in 33 (66%) samples, and 2 or 3 apical foramina were detected in 14 (28 %) and 3 (6%) samples, respectively. In 18.5 (37%) samples the apical foramina were located centrally, and in 31 (62%) they were located laterally. CONCLUSION: A complex morphology of the mandibular first premolars was observed with a high prevalence of multiple root canal systems.

IL-17 receptor A signaling is protective in infection-stimulated periapical bone destruction.

IL-17 is a pleiotropic cytokine produced by Th17 T cells that induces a myriad of proinflammatory mediators. However, different models of inflammation report opposite functional roles of IL-17 signal in terms of its effects on bone destruction. In this study we determined the role of IL-17RA signal in bone resorption stimulated by dentoalveolar infections. Infrabony resorptive lesions were induced by surgical pulp exposure and microbial infection of mouse molar teeth. IL-17 was strongly induced in periapical tissues in wild-type (WT) mice by 7 d after the infection but was not expressed in uninfected mice. Dentoalveolar infections of IL-17RA knockout (KO) mice demonstrated significantly increased bone destruction and more abscess formation in the apical area compared with WT mice. Infected IL-17RA KO mice exhibited significantly increased neutrophils and macrophages compared with the WT littermates at day 21, suggesting a failure of transition from acute to chronic inflammation in the IL-17RA KO mice. The expression of IL-1 (both α and ß isoforms) and MIP2 were significantly upregulated in the IL-17RA KO compared with WT mice at day 21 postinfection. The development of periapical lesions in IL-17RA KO mice was significantly attenuated by neutralization of IL-1ß and MIP2. Taken together, these results demonstrate that IL-17RA signal seems to be protective against infection-induced periapical inflammation and bone destruction via suppression of neutrophil and mononuclear inflammation.

Alkaline conditions can affect the volume and chemical characteristics of dental gutta-percha.

The effects of alkaline pH on the size and surface characteristics of gutta-percha were studied. Forty ProTaper Universal-F2 gutta-percha cones (GPC) were stored individually for 8-weeks. GPC were distributed into 2 groups (n = 20) based on the storage solutions' pH (pH7, pH12). The GPC volume was measured after 1,2,3,4 and 8-weeks using water displacement method and compared to the baseline volume. The surfaces of representative GPCs were analysed using Raman spectroscopy and assessed later using Scanning Electron Microscopy with Energy-Dispersive X-Ray Spectroscopy (EDS). Samples t test was used to compare the change in volume of GPC and a repeated measures Analysis of Variance (ANOVA) was used to compare the effects of storage durations. After 8-weeks, GPCs aged in high-pH exhibited significant drop in their volume (16%) compared with GPCs aged in water (2.5%). The surface of GPCs stored in water or high-pH both demonstrated structural and chemical alterations in comparison with non-aged GPCs.

Exome array identifies functional exonic biomarkers for pediatric dental caries.

BACKGROUND: Pediatric dental caries is common among Arab children, however we are still searching for possible genes and molecular mechanisms that influence caries development. AIM: To identity genetic predispositions of dental caries among Saudi children with high DMFT (Decayed, Missing, and Filled Teeth). DESIGN: This case-control study analysed putative functional exonic-variants (n = 243,345) to study the molecular genetics of pediatric caries with high dmft index, 8.75 ± 4.16 on Arab-ancestry subjects with primary dentition (n = 111; 76 cases, dmft>5 and 35 controls, dmft = 0). RESULTS: Pediatric caries is significantly associated with single nucleotide polymorphisms (SNP) in the GRIN2B-rs4764039C (p-value = 2.03 × 10-08) and CFH-rs1065489G (p-value = 8.26 × 10-08) genes, even after Bonferroni correction. Irregular tooth brushing habits (p = 0.0404) and irregular dental visits (p = 0.0050) are significantly associated with caries. Functional enrichment analysis of significant genes is associated with calcium-activated chloride channel, Staphylococcus aureus infection, and N-linked glycosylation. CONCLUSION: Genetic predispositions are found to be significantly associated with the high prevalence of pediatric caries, which is a disorder of multigene-environment interaction. The significant functional exonic variants identified can be biomarkers for the early diagnosis of pediatric dental caries in Arabs.

Preparation of a toothpaste containing theobromine and fluoridated bioactive glass and its effect on surface micro-hardness and roughness of enamel.

The aim was to synthesize a toothpaste and analyze its effect on surface micro-hardness and roughness of enamel. Basic paste was prepared by using basic ingredients. Theobromine (0.2 wt%) and laboratory synthesized fluoridated-bioactive glass (F-BG, 4 wt%) were added to it. Post-demineralization, 36 enamel blocks were divided into six groups that were brushed with their respective toothpaste+artificial saliva (AS): group 1 (control): basic paste; group 2: basic paste+theobromine; group 3: commercial theobromine toothpaste; group 4: commercial BG toothpaste; group 5: basic paste+F-BG; and group 6: basic paste+theobromine+F-BG. On micro-hardness analysis, group 6 performed best, followed by group 4. Surface roughness results showed the maximum decrease in roughness values for group 6, followed by group 5. Treatment with toothpaste composition containing theobromine+F-BG resulted in the enamel's increased micro-hardness and decreased surface roughness.

Efficacy of the Rotary Instrument XP-Endo Finisher in the Removal of Calcium Hydroxide Intracanal Medicament in Combination with Different Irrigation Techniques: A Microtomographic Study.

OBJECTIVES: This study aims to evaluate the efficacy of the rotary instrument XP-endo Finisher for the removal of Ca(OH)2 aided by different irrigation regimens. METHODS: Sixteen double-rooted upper premolar human teeth were selected for the study. Thirty-two canals were prepared using a ProTaper Next rotary system up to X3. Then, the canals were filled with Ca(OH)2. The volume of Ca(OH)2 inside the canals was measured by microcomputed tomography (micro-CT). After that, the teeth were randomly allocated into two experimental groups, i.e., A and B (n = 16 canals). In group A, Ca(OH)2 was removed using the master apical file (X3). In group B, Ca(OH)2 was removed using a XP-endo finisher. In half of both groups (n = 8), syringe irrigation (SI) was used, while passive ultrasonic irrigation (PUI) was used for the other half. After removal, the remaining volume of Ca(OH)2 was measured. All data were statistically analyzed using two-way ANOVA with Tukey's post hoc test. RESULTS: The percentages of remaining Ca(OH)2 in the apical thirds of all canals were significantly higher as compared with the middle and coronal thirds in all groups (p < 0.05). There was no significant difference between different files and techniques (p > 0.05). CLINICAL SIGNIFICANCE: This study presents a new method for the removal of Ca(OH)2 from root canals.

Effect of Sterilization on Cyclic Fatigue Resistance of Proflexendo Endodontic Rotary Files.

BACKGROUND: Proflexendo file (Nexen, Houston, TX, USA) is a recently developed, novel nickel-titanium rotary file. However, several physical properties of the Proflexendo system remain to be investigated. OBJECTIVES: The aim of this study was to determine the effect of sterilization on cyclic resistance of Proflexendo files. MATERIAL AND METHODS: A total of 120 unused Proflexendo rotary files (40 each of file sizes 40/0.04, 30/0.04 and 20/0.06) were used in this study. Each set of files was subdivided into four groups of ten files. Group 1 did not undergo any sterilization (control), Group 2 underwent two rounds (2×) of sterilization, Group 3 five rounds (5×) and Group 4 ten rounds (10×). Cyclic fatigue resistance was tested using an artificial canal with a 5-mm radius curve. RESULTS: The nonsterilized size 30/0.04 files had the highest cycles to failure, followed by the nonsterilized size 40/0.04 and 20/0.06 files (P < 0.001). With increasing rounds of sterilization, cycles to failure reduced for sizes 40 (2×, 5× and 10×) and 30 (2×) files compared with nonsterilized sizes 40 (P < 0.05) and 30 files (P < 0.001), respectively. CONCLUSION: Under the conditions of the current study, the results provide preliminary evidence that autoclave sterilization of Proflexendo rotary files reduced their cyclic fatigue resistance, except for size 20 (2× and 5×) and 30 (10×) files, in which resistance increased. Single use of this file is recommended to reduce the risk of separation.

Influence of culture change on the perception of fear and anxiety pathways in Endodontics: A pilot proof of concept study.

This study assessed the influence of cultural changes (known as acculturation) on pathways of fear and anxiety in Endodontics. A purposive sampling technique identified patients of Saudi Arabian descent living in Australia and Saudi Arabia. Only patients with root canal fillings (or treatment planned for endodontic treatment) were included. Patients with intellectual disabilities, surgical root therapy, and aged under 20 were excluded. Consenting patients attending the dental clinics of University of Griffith University, Australia and University of Dammam, Saudi Arabia completed the "My Endodontic Fear Questionnaire." Three hundred and twenty-four patients (21-75 years) were included, 90% of participants reported more than one pathway. Australian Saudi Arabians mainly utilised vicarious pathway (94.9%), whilst Saudi Arabians utilised the verbal threat (93.5%) and parental pathway (78.3%). This study highlights the possible role of acculturation on the perception of fear and anxiety in Endodontics; however, further research with other ethnic groups is essential to enhance our understanding.

Evaluation of the fit of zirconia three-unit fixed partial dentures fabricated by different impression techniques.

AIM: The aim of the present study was to evaluate the marginal and internal fit of zirconium fixed partial denture using different impression techniques. METHODS: A Nissin Typodont model, including maxillary central incisor and canine with missing lateral incisor, was selected for the present study. Thirty zirconium frameworks were fabricated following three impression techniques (N = 10), conventional silicone impression (group C), scanned dental impression (group S), and Trios 3 (3Shape) intraoral scanner (group T). An extra-fine milling strategy was applied. RESULTS: Group T had the smallest discrepancy compared to groups C (P = 0.006) and S (P = 0.052) at the marginal level, whereas it was larger at the incisal tip. Discrepancies in group T were smaller than group C (P = 0.004) when measured at the axial walls, and smaller than group S (P = 0.045) when measured at the chamfer area for the central teeth only. Samples in group T showed a greater percentage of equally extended restorations (52.5%), while other groups were mainly underextended (group C: 63.7%, group S: 68.8%). CONCLUSION: Better adaptation was achieved with the intraoral scanner group, except at the incisal tip. Conventional and scanned impressions revealed a greater percentage of underextended restorations.

Micro-computed tomography analysis of gap and void formation in different prefabricated fiber post cementation materials and techniques.

OBJECTIVE: The study was built around the objective of determining the variances in the gap and void formation around cemented prefabricated fiber posts with two different cementation materials and techniques with micro-computed tomography (µCT). METHODS: Standardized acrylic resin roots (N = 40) with prefabricated fiber posts (RelyX™ Fiber Post 3D) were split into four sets (n = 10) based on many types of cementation materials and techniques. In the first group, resin cement (RelyX™ Unicem) was inserted to the canals via root canal tips. In the second group, the same cement was injected, and a microbrush was used to distribute the cement inside the canal. In the third group, dual polymerizing resin cement (MultiCore® Flow) was injected into the canals by using root canal tips. In the fourth group, the same cement was injected, and a microbrush was used to distribute the cement inside the canal. The gap and void formation in the cement and the root canals was evaluated with µCT. IBM SPSS Statistics was used to perform the statistical evaluation, then the Kolmogorov-Smirnov test of normality and Kruskal-Wallis H test to compare these variables with respect to the all groups significant difference (a = 0.05). RESULTS: The study outlined no difference of significance when evaluating the gap and void formation within the experimental groups (P > 0.05). CONCLUSION: There was a certain amount of void and gap formation inside all of the tested specimens. However, no significant variances were found.

Comparing ProFile Vortex to ProTaper Next for the efficacy of removal of root filling material: An ex vivo micro-computed tomography study.

AIM: This study compared the efficacy of ProFile Vortex (PV) with that of ProTaper Next (PTN) for the removal of root canal filling material. MATERIALS AND METHODS: Twenty-six mesial canals of extracted mandibular first molars were instrumented, obturated with gutta-percha and sealant, and randomly allocated to a PTN (X3, X2, or X1) or PV group. The percentage of remaining material, amount of dentin removed, and extent of transportation were assessed using micro-computed tomography. The total time required for removal of material was calculated. RESULTS: Both systems were effective for material removal (p ≤ 0.001). Less time was required to remove material using PV (256.43 ±â€¯108.95 s) than using PTN (333.31 ±â€¯81.63 s; p ≤ 0.05). PV and PTN files removed approximately 84% and 78% of the filling material, respectively (p > .05). There was no significant canal transportation in either group. PV and PTN files removed 1.32 ±â€¯0.48 mm3 and 1.63 ±â€¯0.67 mm3 of the dentin, respectively (p = .18). CONCLUSION: Our findings suggest that PV is as effective as PTN for removal of root canal filling material. Therefore, PV can be considered for use in endodontic retreatment, although more effective files or techniques are still required.

Push-out bond strength of different types of mineral trioxide aggregate in root dentin.

OBJECTIVE: The objective of this study was to measure the push-out bond strength of three types of mineral trioxide aggregate (MTA) materials in root dentin. METHODS: The study was carried out at the College of Dentistry, Imam Abdulrahman Bin Faisal University from March 2014 to January 2015. Thirty extracted maxillary central incisors were selected, instrumented, irrigated, and randomly assigned into three groups (n = 10): Group 1 - Ortho MTA; Group 2 - MTA Angelus; and Group 3 - ProRoot MTA. Materials were mixed following the manufacturers' recommendations and canals were filled. Teeth were stored in distilled water for 6 months. The push-out bond strength was evaluated using 2-mm thick coronal root sections. The data were analyzed with one-way ANOVA and Tukey-Kramer multiple comparison tests statistically significant at P < 0.05. RESULTS: The mean bond strength values were 68.69 ± 29.63 MPa for Ortho MTA, 42.54 ± 32.78 MPa for MTA Angelus, and 72.75 ± 26.27 MPa for ProRoot MTA groups. There were no significant differences between the bond strengths of tested materials (P > 0.05). CONCLUSION: Ortho MTA, MTA Angelus, and ProRoot MTA materials showed similar push-out bond strength values in root dentin.

The Effect of Heating Time and Temperature on Epoxy Resin and Calcium Silicate-based Endodontic Sealers.

INTRODUCTION: With the growing use of warm obturation techniques during endodontic treatment, more interest is directed toward sealers' compatibility with heat. This study aimed to evaluate the effect of heat application duration and temperature on epoxy resin- and calcium silicate-based sealers using chemical and thermogravimetric analyses. METHODS: Freshly mixed samples (n = 5/group) of each sealer were heated at 200°C or 250°C for 30 or 60 seconds. Additional 2 sets of samples were examined directly after mixing or after setting without heat exposure. Raman spectroscopy was used to identify changes in the chemical structure, and a 2-way analysis of variance was performed to compare values of measurable peaks that exhibited changes. Additionally, Thermogravimetric Analysis (TGA) was used to evaluate the effect of heat on mass change where sealers were heated to 250°C at a rate of 20°C/min (11-minute duration) or maintained at 37°C for 8 hours. RESULTS: No differences were detected among all the spectra of calcium silicate samples of different groups, while TGA revealed 15% and 18% weight loss upon heating at 250°C and 37°C, respectively. For the resin sealer, significant differences were detected when samples were heated for 60 seconds, involving bonds of benzene rings and aromatic amines in the uncured resin. TGA revealed minimal changes in the sealer mass (1.2% and 1.8%) on heating at 250°C and 37°C, respectively. CONCLUSIONS: Heat application duration and temperature can affect the chemical structure of epoxy resin sealers. The consideration of endodontic sealer compatibility as well as the duration of heat application is essential when warm vertical obturation is used.

Cutting efficiency of different dental materials utilized in an air abrasion system.

OBJECTIVES: The aim of the present study was to test cutting efficiency of different materials against conventional alumina in an air abrasion system. MATERIALS AND METHODS: The powder samples were divided into three groups: Group 1 - alumina (control), Group 2 - 45S5 bioactive glass, and Group 3 - hydroxyapatite. 30 microscope glass slides of 0.5 mm thickness were used as an alternative of human enamel and were also divided randomly into these three groups. The time taken by the abrasive particles to cut a hole through the microscope glass slide was recorded with a stop watch. In addition, morphology of the particles was observed through scanning electron microscopy (SEM). A t-test was used to compare the times taken to cut a hole through the microscope glass slides, and the level of significance was set at P < 0.05. RESULTS: The mean time taken to cut a hole through the microscope glass slide was 2.96 s and 23.01s for Groups 1 and 2, respectively, whereas powder of Group 3 did not cut after 120 s. The differences between cutting times of Groups 1 and 2 were statistically significant (P < 0.05). The SEM micrographs revealed coarse angular shape for particles of Groups 1 and 2 but Group 3 particles were with round ends and presence of smaller particles was also observed in Groups 2 and 3. CONCLUSION: The alumina particles demonstrated excellent cutting efficiency followed by 45S5 particles. The use of bioactive glass particles should be encouraged for cutting purposes whenever a shortage of time for practitioners is not a concern.

Evaluation of root canal morphology of maxillary second premolars in a Saudi Arabian sub-population: An in vitro microcomputed tomography study.

AIM: To investigate the root canal morphology of maxillary second premolars in a Saudi Arabian subpopulation using microcomputed tomography (micro-CT). METHODOLOGY: Micro-CT analysis was performed on 100 maxillary second premolars. The anatomy of each tooth (number of roots, canals, orifices, and apical foramina, and the presence of apical deltas and accessory canals) was analyzed from reconstructed three-dimensional images. RESULTS: The most common morphology was a single root (67%), followed by two roots (30%), and three roots (3%). Regarding the canal morphology, most teeth (65%) contained two canals, followed by 30% with one canal, and 5% with three canals. One orifice was observed in 55% of teeth, and two orifices were detected in 45% of teeth. According to the Vertucci classification, the most common canal types were IV and V (both found in 23% of teeth), followed by type I (17%), type III (9%), type II (7%), and type VII (2%). Additional types that were inconsistent with the Vertucci classification were recorded in 19% of teeth. CONCLUSION: The root canal morphology of maxillary second premolars in the Saudi Arabian subpopulation is complex and requires cautious evaluation prior to endodontic treatment.