Cone-beam computed tomography (CBCT) was used in this study to characterize the anatomy of the maxillary first premolar in a Malaysian subpopulation, using two classification approaches: Vertucci (1984) and Ahmed and Dummer (2017). A sample of 200 CBCT scans yielding 282 maxillary first premolars was collected from the Oral Radiology Unit, Faculty of Dentistry, University Sains Islam Malaysia. Root numbers and canal configurations per tooth were cataloged using the typologies established by Vertucci (1984) and Ahmed and Dummer (2017). Relationships involving sex, ethnicity, and tooth position were evaluated via the Chi-squared test (P = 0.05). A single root appeared in 64.2% of maxillary first premolars, representing the majority in both male and female subjects. Among Malays and Chinese, one root was found in 60% (n = 123) and 81.8% (n = 54) of cases, respectively; in contrast, among Indians, two roots were found in 63.6% of cases (n = 11; P < 0.05). Root and canal counts showed no statistically meaningful difference between right- and left-side maxillary first premolars in either classification system. Vertucci’s Type IV was the most frequently encountered configuration, exhibiting significant differences between Malay and Indian groups, though variation across ethnicities did not reach significance. According to the schema of Ahmed and Dummer, the 2FPB1P1 arrangement emerged as the most common morphology, particularly in the Malay (35.1%, n = 72) and Indian (63.6%, n = 7/11) cohorts, where clear gender-based disparities were observed. The 1FP1-2 form was prevalent among Chinese individuals (24.2%, n = 16). The Ahmed and Dummer classification revealed statistically significant differences in the distribution of canal configurations across ethnic groups. This subpopulation displayed a range of root and canal anatomical presentations. Classification systems adequately capture the anatomy of the maxillary first premolar. That said, the framework proposed by Ahmed and Dummer provides a more accurate depiction of the intricate anatomical canal configurations in teeth with multiple roots and root canals.
