Three-dimensional evaluation of pulp chamber volume and dimensions across skeletal and dental malocclusions using CBCT: a retrospective cross-sectional study

Abstract

Aim To evaluate and compare pulp chamber volume(PCV) and dimensions of maxillary and mandibular first molars, and maxillary central incisors, among subjects with varying vertical and anteroposterior dental and skeletal malocclusions using cone beam computed tomography(CBCT).

Materials and methods A retrospective, cross-sectional analysis was conducted using CBCT scans from 184 Jordanian adults(mean age 24.22 ± 7.50 years). Subjects were categorized according to vertical facial pattern(short, average, and long face) and molar interdigitations (cusp-to-fossa, CFM; cusp-to-cusp, CCM). PCV and dimensions were measured using ITK-SNAP software. Data were analyzed with non-parametric tests and multiple linear regression.

Results For molars, PCV was significantly smaller in short-faced individuals than in average and long-face groups(P ≤ 0.001 across jaws), while average vs. long face was nonsignificant. In incisors, PCV differed among all three vertical groups (P = 0.001). Enamel thickness and crown height were also reduced in this group. CCM was associated with smaller PCV and reduced enamel and crown dimensions. Incisor PCV did not significantly differ by tooth contact status. Age, gender, molar interdigitation, and vertical pattern(for incisors) were significant predictors of PCVs (P ≤ 0.05).

Conclusion PCV and dimensions are influenced by vertical skeletal pattern, with short-faced individuals showing the smallest volumes. Molar interdigitation affects molar PCV, with CCM linked to reduced volumes. PCV showed a linear inverse association with age and are generally larger in males. Posterior crossbite correlates with increased molar PCV.

Clinical relevance Skeletal and occlusal variation should be considered during endodontic access planning and when interpreting radiographs to avoid misjudging pulp size in patients with atypical skeletal and dental relationships.