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Öğe Assessment of bone quality of apical periodontitis treated with MTA plug and regenerative endodontic techniques(Wiley, 2022) Aricioglu, Banu; Gunacar, Dilara Nil; Kosar, Tugba; Cikman, Ahter Sanal; Hatipoglu, Fatma Pertek; Maras, EdanurFractal analysis (FA) is a quantitative, objective and non-invasive method that facilitates the characterisation of the tissue architecture. This study aims to compare the periapical healing at 1-year follow-up by evaluating newly generated trabecular bone with FA after Mineral trioxide aggregate (MTA) plug and regenerative endodontic treatment (RET). A total of 55 asymptomatic teeth with a single-canal, open apex and periapical lesion, treated with MTA plug or RET, were evaluated retrospectively. After considering the inclusion/exclusion criteria, FA was conducted on 30 periapical images using the box-counting method. In both groups, a significant decrease was observed in the periapical lesion size at 1-year follow-up (p < 0.01). However, there was no significant difference between the MTA plug and RET (p > 0.01). Significantly higher fractal dimension values were detected at 1-year follow-up in both MTA plug and RET cases (p < 0.01). However, the difference was not significant between the groups (p > 0.01). Both procedures seem to improve periapical healing with a new resistant bone of similar density and complexity.Öğe Assessment of the Prevalence of Middle Mesial Canal in Mandibular First Molar: A Multinational Cross-sectional Study with Meta-analysis(Elsevier Science Inc, 2023) Hatipoglu, Fatma Pertek; Magat, Guldane; Hatipoglu, Omer; Taha, Nessrin; Alfirjani, Suha; Zainal, Imran; Lehmann, Anna PaulinaBackground: An additional canal found in the mandibular first molar (M1M) is the middle mesial canal (MMC), which is often missed during root canal treatment. In this study, the prevalence of MMC in M1M on cone-beam computed tomography (CBCT) images was evaluated in 15 countries, along with the effect of some demographic factors on its preva-lence. Methods: Deidentified CBCT images were scanned retrospectively, and the ones including bilateral M1Ms were included in the study. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating three planes (coronal, sagittal, and axial) after a 3-dimensional alignment of the long axis of the root(s). The presence of an MMC in M1Ms (yes/no) was identified and recorded. Results: In total, 6304 CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries (P < .05). MMC prevalence ranged from 1% to 23%, and the overall prevalence was 7% (95% confidence interval [CI]: 5%-9%). No significant differences were found between the left and right M1M (odds ratio = 1.09, 95% CI: 0.93, 1.27; P > .05) or between genders (odds ratio= 1.07, 95% CI: 0.91, 1.27; P > .05). As for the age groups, no significant differences were found (P > .05). Conclusions: The prevalence of MMC varies by ethnicity, but it is generally estimated at 7% worldwide. Physicians must pay close attention to the presence of MMC in M1M, especially for opposite M1Ms, due to the prevalence of MMC being significantly bilateral. (J Endod 2023;49:549-558.)Öğe Assessment of the Prevalence of Radix Entomolaris and Distolingual Canal in Mandibular First Molars in 15 Countries: A Multinational Cross-sectional Study with Meta-analysis(Elsevier Science Inc, 2023) Hatipoglu, Fatma Pertek; Magat, Guldane; Hatipoglu, Omer; Al-khatib, Hanan; Elatrash, Anas S.; Abidin, Imran Zainal; Kulczyk, TomaszAim: The aim of this study was two-folded: i) to assess the prevalence of Distolingual Canal (DLC) and Radix Entomolaris (RE) in Mandibular First Molars (M1Ms), using Cone Beam Computed Tomography (CBCT) images and ii) to assess the impact of sociodemographic factors on the prevalence of these conditions worldwide.Methods: CBCT images were scanned retrospectively and the ones including bilateral M1Ms were included in the study. The evaluation was performed by 1 researcher in each country, trained with CBCT technology. A written and video instruction program explaining the protocol to be followed step-by-step was provided to all observers to calibrate them. The CBCT imaging screening procedure consisted of evaluating axial sections from coronal to apical. The presence of DLC and RE in M1Ms (yes/ no) was identified and recorded.Results: Six thousand three hundred four CBCTs, representing 12,608 M1Ms, were evaluated. A significant difference was found between countries regarding the prevalence of both RE and DLC (P , .05). The prevalence of DLC ranged from 3% to 50%, and the overall prevalence was 22% (95% CI: 15%-29%). RE prevalence ranged from 0% to 12%, and the overall prevalence was 3% (95% CI: 2%-5%). There were no significant differences between left and right M1Ms or between genders for either DLC or RE (P . .05).Conclusion: The overall prevalence of RE and DLC in M1Ms was 3% and 22%. Additionally, both RE and DLC showed substantial bilaterally. These variations should be considered by endodontic clinicians during endodontic procedures in order to avoid potential complications. (J Endod 2023;49:1308-1318.)Öğe Association Between Etiological Factors and Dentin Hypersensitivity: A Cross-Sectional Study in Turkey(Marmara Univ, Inst Health Sciences, 2023) Hatipoglu, Oemer; Hatipoglu, Fatma PertekObjective: This study purposed to estimate the prevalence of DH and how effective the etiological factors are in the development of DH in Turkey.Methods: Demographic features, hygiene habits, bruxism, beverage habits, parafunctional habits, smoking, and other medical problems were asked. Air was blasted to the teeth via the air-water syringe for 3 seconds. The Visual Analogue Scale was used to measure DH sensitivity, and data were recorded in the 0-100 mm range, and 5 mm and higher were considered DH. The attrition, abrasion, erosion, abfraction per dental type (Incisal OR Canine OR Premolar OR Molar) were recorded. The same procedure was applied for abnormal tooth position and gingival recession.Results: A total of 4476 teeth and 236 individuals were evaluated. Significantly higher DH frequency was observed in females (p= .034), the 40-55 age range (p= .009), and non-smokers (p= .016). Those who brushed their teeth three times a day or more (p< .001), preferred horizontal technique (p= .017), used toothbrushes with a hard bristle (p< .001) exhibited higher DH frequency. There was no significant difference in DH regarding bruxism, acidic beverage consumption, vomiting, and reflux (p> .05).Conclusion: DH is a multi-etiological symptom affected by demographic attributes, hygiene, and other habits. Clinicians should painstakingly distinguish the source of DH to gain the long-term success of DH treatment, which depends on many etiological factors.Öğe Attitude and practice of regenerative endodontic procedures among endodontists and paediatric dentists: A multinational survey from 13 countries(Wiley, 2023) Hatipoglu, Fatma Pertek; Hatipoglu, Oemer; Taha, Nessrin; Lehmann, Anna Paulina; Aldhelai, Thiyezen Abdullah; Madfa, Ahmed A.; Al-Haddad, AfafBackground: Regenerative endodontics (RET) refers to biologically based procedures that aim to restore damaged tooth structures and reinstate the pulp-dentine complex to its normal physiological state.Aim: The purpose of this study was to examine the attitudes and practices of endodontists and paediatric dentists regarding RET.Design: A survey was conducted among endodontists and paediatric dentists from 13 countries. A number of factors were evaluated, including frequency of RET application, followed guidelines, disinfection techniques, intracanal medication type, scaffold type, preferred coronal seal material, and follow-up period.Results: Among the 1394 respondents, 853 (61.2%) and 541 (38.8%) were endodontists and paediatric dentists, respectively. Almost half (43%) of participants have not performed RET yet. The American Association of Endodontics guideline (47.3%) was selected as the primary source for the clinical protocol. The most frequently selected irrigant solution was 1.5%-3% NaOCl at the first (26.1%) and second (13.6%) sessions. A blood clot (68.7%) and MTA (61.9%) were the most frequently selected scaffold type and coronal barrier. Most participants preferred a 6-month follow-up period.Conclusion: According to this survey, deviations exist from current RET guidelines regarding all aspects evaluated. Standardizing clinical protocols and adhering to available guidelines would help to ensure more predictable outcomes.Öğe Automatic deep learning detection of overhanging restorations in bitewing radiographs(Oxford Univ Press, 2024) Magat, Guldane; Altindag, Ali; Hatipoglu, Fatma Pertek; Hatipoglu, Omer; Bayrakdar, Ibrahim Sevki; Celik, Ozer; Orhan, KaanObjectives This study aimed to assess the effectiveness of deep convolutional neural network (CNN) algorithms for the detecting and segmentation of overhanging dental restorations in bitewing radiographs.Methods A total of 1160 anonymized bitewing radiographs were used to progress the artificial intelligence (AI) system for the detection and segmentation of overhanging restorations. The data were then divided into three groups: 80% for training (930 images, 2399 labels), 10% for validation (115 images, 273 labels), and 10% for testing (115 images, 306 labels). A CNN model known as You Only Look Once (YOLOv5) was trained to detect overhanging restorations in bitewing radiographs. After utilizing the remaining 115 radiographs to evaluate the efficacy of the proposed CNN model, the accuracy, sensitivity, precision, F1 score, and area under the receiver operating characteristic curve (AUC) were computed.Results The model demonstrated a precision of 90.9%, a sensitivity of 85.3%, and an F1 score of 88.0%. Furthermore, the model achieved an AUC of 0.859 on the receiver operating characteristic (ROC) curve. The mean average precision (mAP) at an intersection over a union (IoU) threshold of 0.5 was notably high at 0.87.Conclusions The findings suggest that deep CNN algorithms are highly effective in the detection and diagnosis of overhanging dental restorations in bitewing radiographs. The high levels of precision, sensitivity, and F1 score, along with the significant AUC and mAP values, underscore the potential of these advanced deep learning techniques in revolutionizing dental diagnostic procedures.Öğe Caries-related salivary parameters and oral microbial flora in patients with type 1 diabetes: A meta-analysis(Wiley, 2022) Hatipoglu, Omer; Onsuren, Asli Sogukpinar; Hatipoglu, Fatma Pertek; Kurt, AycaObjectives This study aimed to conduct a meta-analysis by synthesising the outcomes of studies that investigated the relationship between type 1 diabetes (T1D) and salivary flow rate (SFR), salivary pH (SpH), salivary buffer capacity (SBC), streptococcus Mutans (SM), and lactobacillus (LB) counts. Material and Methods The PRISMA statement guide was followed for the meta-analysis. Electronic databases were searched, and study selection and data collection processes were performed. The risks of bias in individual studies and across studies were assessed. Mean differences (MD) and Odds Ratio (OR) were used to measure the effect estimates in the comparisons. Results 29 studies were included in the qualitative and quantitative syntheses. Significantly higher SFR (MD = -0.22, CI: -0.26, -0.18; p < 0.001) and SpH (MD = -0.59, CI: -0.81, -0.36; p < 0.001) were observed in the healthy individuals than T1D individuals. No significant difference was observed among groups in terms of SBC (MD = 0.10, CI: -0.46,0.66; p = 0.73). An increased odds ratio of SM counts were observed regarding the T1D (OR = 3.09, 95% CI: 1.16, 8.20; p = 0.02). No association was found between LB counts and T1D (OR = 2.15, 95% CI: 0.38, 11.98; p = 0.38). Conclusions Subjects with T1D have a significantly lesser SFR and SpH than healthy individuals. But no significant difference is available in terms of SBC. Lower SM counts were observed in individuals with T1D, while no association was observed regarding LB counts. The tendency to dental caries is more likely in subjects with T1D due to lower SFR, SpH, and higher SM.Öğe Comparison of degree of conversion performance of bulk-fill resin composites: A systematic review and network meta-analysis of in vitro studies(Elsevier Sci Ltd, 2024) Hatipoglu, Omer; Par, Matej; Hatipoglu, Fatma PertekObjectives: To systematically compile data on the degree of conversion (DC) for bulk-fill composites using a network meta-analysis. Methods: A systematic search for in vitro studies of DC of bulk-fill composites was performed in PubMed, Web of Science, Scopus, and Open Grey. Risk of bias within studies and due to missing evidence was assessed using the Joanna Briggs Institute scoring system and ROB-MEN tool, respectively. The primary outcome was the DC of bulk-fill composites. Surface Under the Cumulative Ranking curve (SUCRA) was used to rank relative performance. Inconsistencies in the model were investigated to ensure its validity and the level of confidence in the network meta-analysis (CINeMA) was assessed. Results: A total of 28 studies were included in the quantitative analysis. The average DC values (%) for 0-h/top, 0h/bottom, 24-h/top, and 24-h/bottom were 59.09, 57.14, 66.73, and 63.87, respectively. According to their SUCRA ranking, the best-performing composites were: SonicFill, Venus Bulk Fill, and SDR (0-h/top), Reveal HD, i-Flow Bulk Fill, and Venus Bulk- Fill (0-h/bottom), Venus Bulk Fill, SDR, and QuiXfil (24-h/top), and Venus Bulk Fill, Aura Bulk Fill, and i-Flow Bulk Fill (24-h/bottom). Incoherence between direct and indirect evidence was identified as the most significant factor affecting confidence. Conclusions: DC values of bulk-fill composites were within the range commonly reported for previous generations of conventional composites, with flowable composites tending to perform better than sculptable composites. High variability in DC data was observed, which may be attributed to incompletely understood methodological differences. Clinical significance: DC is a fundamental parameter that influences multiple mechanical and biological properties of resin composites and is particularly relevant for the group of bulk-fill composites that are designed for use in thick layers.Öğe Comparison of mandibular morphometric parameters in digital panoramic radiography in gender determination using machine learning(Springer, 2024) Pertek, Hanife; Kamasak, Mustafa; Kotan, Soner; Hatipoglu, Fatma Pertek; Hatipoglu, Omer; Kose, Taha EmreObjectiveThis study aimed to evaluate the usability of morphometric features obtained from mandibular panoramic radiographs in gender determination using machine learning algorithms.Materials and methodsHigh-resolution radiographs of 200 patients aged 20-77 (41.0 +/- 12.7) were included in the study. Twelve different morphometric measurements were extracted from each digital panoramic radiography included in the study. These measurements were used as features in the machine learning phase in which six different machine learning algorithms were used (k-nearest neighbor, decision trees, support vector machines, naive Bayes, linear discrimination analysis, and neural networks). To evaluate the reliability, we have performed tenfold cross-validation and we repeated this 10 times for every classification process. This process enhances the reliability of the results for other datasets.ResultsWhen all 12 features are used together, the accuracy rate is found to be 82.6 +/- 0.5%. The classification accuracies are also compared using each feature alone. Three features that give the highest accuracy are coronoid height (80.9 +/- 0.9%), condyle height (78.2 +/- 0.5%), and ramus height (77.2 +/- 0.4%), respectively. When compared to the classification algorithms, the highest accuracy was obtained with the naive Bayes algorithm with a rate of 84.0 +/- 0.4%.ConclusionMachine learning techniques can accurately determine gender by analyzing mandibular morphometric structures from digital panoramic radiographs. The most precise results are achieved by evaluating the structures in combination, using attributes obtained from applying the MRMR algorithm to all features.Öğe Effectiveness of endodontic complexity assessment tool (E-CAT) on the undergraduate students in an endodontic training program and its predictive capability on complications(Wiley, 2023) Hatipoglu, Fatma Pertek; Akinci, LeventIntroductionDental students face a number of challenges when it comes to performing root canal treatments (RCTs). The Endodontic Complexity Assessment Tool (E-CAT) was developed to assist dental practitioners in assessing the complexity of RCTs before beginning treatment. Materials and MethodsThe E-CAT was filled out independently by both the educator and the student. To allow educators to record scores and complexity classes, they transferred their and students' forms to the website . Students began endodontic treatment after learning about the complexity level of the case. The educators were responsible for recording any complications encountered in every case from the outset to 1 month after treatment. ResultsA total of 70 students, 33 in fourth and 37 in fifth-grade, were included in the study. In the cases with higher E-CAT scores, complications such as misdiagnosed, faulty access cavity, furca or coronal third perforation, insufficient root canal instrumentation, working length loss, canal blockage, overpreparation, incomplete root canal filling and overfilling were experienced significantly more often compared to the cases with lower E-CAT scores (p < .05). The number of complications (r = .40, p < .001), treatment sessions (r = .44, p < .001), and teacher support (r = .24, p < .001) positively correlated with E-CAT score (p < .05). ConclusionThe E-CAT is an effective tool for assisting dental students in understanding technical challenges, such as complex root canal anatomy and possible complications during treatment. Educators can also use e-CAT to pre-select clinical cases and standardise student training by offering cases of equal complexity.Öğe Evaluation of Color Stability of Experimental Dental Composite Resins Prepared from Bis-EFMA, A Novel Monomer System(Technical Assoc Photopolymers,Japan, 2021) Hatipoglu, Omer; Turumtay, Emine Akyuz; Saygin, Aysegul Goze; Hatipoglu, Fatma PertekColor stabilities of experimental composite resins based on Bis-EFMA (a novel bisphenol A [BPA]-free monomer system) with 3M ESPE FiltekTM Z250 (FZ) and experimental composite resins based on bisphenol A-glycidyl methacrylate (Bis-GMA) and urethane dimethacrylate (UDMA) were compared. Bis-EFMA was synthesized via the reaction between 9,9-bis[4-(2-hydroxyethoxy)phenyl]fluorene and 2-(methacryloyloxy)ethyl isocyanate. Experimental Bis-EFMA-, Bis-GMA-, and UMDA-based composites were prepared (20% of each of Bis-EFMA, Bis-GMA, UDMA, or triethylene glycol dimethacrylate (TEGDMA) and 60% glass filler). Eighty composite resin materials were produced (n=5). The initial color values of composites on the first day, first week, and after the first month after immersion into black tea, coffee, cola, and water solutions were measured using a spectrophotometer (VITA Easyshade (R) V; Zahnfabrik, Bad Sackingen, Germany) against a white background. UDMA- and Bis-EFMA-based composite resins exhibited significantly less Delta E and Delta L compared to Bis-GMA based composite resins (p < 0.05). No significant difference was found between FZ and other composites (p > 0.05). Tea and coffee caused significant changes in total color, light value, red-green, and blue-green coordinate values changes (Delta E, Delta L, Delta a, and Delta b, respectively) compared to water and cola (p < 0.05). At one month compared to one week and one day, Delta E, Delta L, Delta a, and Delta b were significantly different (p < 0.05). Bis-EFMA has the potential to be used in commercial dental composites as a substitute for Bis-GMA in terms of better color stability.Öğe Factors Affecting the Decision-making of Direct Pulp Capping Procedures among Dental Practitioners: A Multinational Survey from 16 Countries with Meta-analysis(Elsevier Science Inc, 2023) Hatipoglu, Omer; Hatipoglu, Fatma Pertek; Javed, Muhammad Qasim; Nijakowski, Kacper; Taha, Nessrin; El-saaidi, Christina; Sugumaran, SurendarIntroduction: Direct pulp capping (DPC) procedures require the placement of a bioactive material over an exposure site without selective pulp tissue removal. This web-based multi centered survey had 3 purposes: (1) to investigate the factors that affect clinicians' decisions in DPC cases, (2) to determine which method of caries removal is preferred, and (3) to evaluate the preferred capping material for DPC. Methods: The questionnaire comprised 3 sections. The first part comprised questions regarding demographic features. The second part comprised questions on how treatment plans change according to factors such as nature, location, number and size of the pulp exposure, and patients' age. The third part composed of questions on the common materials and techniques used in DPC. To estimate the effect size, the risk ratio (RR) and 95% confidence interval (CI) were calculated using a meta-analysis software. Results: A tendency toward more invasive treatment was observed for the clinical scenario with carious-exposed pulp (RR = 2.86, 95% CI: 2.46, 2.32; P < .001) as opposed to the clinical scenario with 2 pulp exposures (RR = 1.38, 95% CI: 1.24, 1.53; P < .001). Complete caries removal was significantly preferred to selective caries removal (RR = 4.59, 95% CI: 3.70, 5.69; P < .001). Among the capping materials, calcium silicate-based materials were preferred over calcium hydroxide-based materials (RR = 0.58, 95% CI: 0.44, 0.76; P < .05). Conclusions: While carious-exposed pulp is the most important factor in clinical decisions regarding DPC, the number of exposures has the least impact. Overall, complete caries removal was preferred over selective caries removal. In addition, the use of calcium silicate-based materials appears to have replaced calcium hydroxide-based materials.Öğe Prediction of root canal lengths and pulp volume of the maxillary permanent first molar based on stature, crown diameters, and facial morphometry(Springer, 2023) Hatipoglu, Fatma Pertek; Aricioglu, Banu; Hatipoglu, Oemer; Kose, Taha Emre; Gunacar, Dilara NilThis study purposed to develop statistical models to predict palatal (PRL), mesial (MRL), and distal (DRL) root canal length and pulp volume (PV) of the maxillary first permanent molar using stature, gender, mesiodistal (MD), and buccopalatal (BP) crown diameters and some facial morphometries. 57 individuals were included in the study. Cone beam computed tomography was used to measure root canal lengths and PV. The PV calculation was carried out using the software ITK-SNAP 3.4.0. PRL was positively correlated with BP, stature, middle facial height, interalar distance, and bicommissural distance (BCD) (p < 0.05). DRL was positively correlated with BP, MD, and stature (p < 0.05). MRL was positively correlated with BP, MD, stature, lower face height, bizygomatic distance, and BCD (p < 0.05). PV was negatively correlated with age and BCD (p < 0.05). Although all models have significant predictive power for the root lengths and PV, no model could explain variances greater than 30%. The highest and lowest predictive ability was obtained for PRL and DRL, respectively. While the most significant predictor was BP for PRL and DRL, it was the age for PV.Öğe Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study(Bmc, 2024) Taha, Nessrin A.; Makahleh, Nisrein; Hatipoglu, Fatma PertekBackground Adequate knowledge of root canal morphology and its variation is essential for success of root canal treatment and to overcome treatemnt failure. The aim of this study was to investigate the root and canal morphology of mandibular anterior teeth using 2 classification systems. Methods 3342 lower anteriors were evaluated from 557 CBCT scans. The images were examined in sagittal, axial and coronal views using a CS 3D imaging software (V3.10.4, Carestream Dental). Demographic data recorded, the number of roots and canal's morphology were described according to Vertucci and Ahmed classifications. Results Frequency of Type I configuration was significantly the highest in incisors and canines (76%, N = 2539), followed by Type III (20.6%, N = 687). Type II (1.1%, N = 37), IV (1.1%, N = 37), and V (0.3%, N = 11) were rarely encountered. 0.9% (N = 31) of the teeth could not be classified with the Vertucci System. The frequency of 2 roots ((2)MA in Ahmed classification) which has no correspondence in the Vertucci classification, was 1.1% (N = 38), it was significantly higher in canines and in females (35 canines and 3 laterals). A moderate correlation in root canal morpology was found between the left and right sides (V > 0.30). 80% (N = 2538) of the teeth did not exhibit any divergence/merging. The bifurcation level occurred mostly in the middle third of the root. Conclusions One fourth of anterior teeth had variation from the simple type I canal configuration and therefore requires attention during treatment. The new classification system offers a more accurate and simplified presentation of canal morphology. Clinical relevance The prevalence and mid root bifurcation of second canal in lower anteriors requires attention to ensure adequate quality root canal treatment without compromising the integrity of teeth.Öğe Root canal morphology of mandibular anterior permanent teeth in Turkish sub-population using two classification systems: a cone-beam computed tomography study(Springer, 2024) Magat, Guldane; Hatipoglu, Omer; Kose, Tuba; Hatipoglu, Fatma PertekThis study examined the root and canal morphology of mandibular anterior teeth (MA) in the Turkish sub-population using cone-beam computed tomography (CBCT), comparing the findings based on Vertucci's and Ahmed et al. classification systems. The CBCT images were acquired using the 3D Accuitomo CBCT device. Images that were deemed suitable for visualizing the roots, canals, and the complete pulp chamber and apex were included in the study. Vertucci and Ahmed et al. classification systems were employed to determine the root canal morphology. 500 CBCT images and 3000 teeth were analyzed. Type I ((1)MA(1)) was the most frequent, followed by Type III ((1)MA(1-2-1)). 3.8% of teeth could not be classified with Vertucci system. In canine teeth, Vertucci type III ((1)MA(1-2-1)) was significantly more prevalent in males than females (p = 0.038) and Type I ((1)MA(1)) was less frequent in individuals aged 41-50 (p < 0.05). Canal divergence/merging was the most common at the middle/apical level for central (15.5%) and lateral (10.3%) teeth, and at the coronal/middle level for canine teeth (1.9%). Bilateral similarity was high for all tooth groups (> 78%). One-third of mandibular incisor teeth have two canals, with a significant number exhibiting canal divergence/merging that was separated in the middle region and merged in the apical region. The Vertucci classification was found to be inadequate in some cases, while Ahmed et al. classification was able to classify all mandibular incisors with a single code. Ahmed et al. classification is a more useful system for classifying all MA.
