Efficacy of clinical and radiological methods to identify second mesiobuccal canals in maxillary first molars.
BACKGROUND
The success of endodontic treatment depends on the identification of all root canals. Technological advances have facilitated this process as well as the assessment of internal anatomical variations. The aim of this study was to compare the efficacy of clinical and radiological methods in locating second mesiobuccal canals (MB2) in maxillary first molars.


METHODS
Fifty patients referred for analysis; access and clinical analysis; cone-beam endodontic treatment of their maxillary first molars were submitted to the following assessments: analysis; access and clinical analysis; cone-beam computed tomography (CBCT); post-CBCT clinical analysis; clinical analysis using an operating microscope; and clinical analysis after Start X ultrasonic inserts in teeth with negative results in all previous analyses.


RESULTS
Periapical radiographic analysis revealed the presence of MB2 in four (8%) teeth, clinical analysis in 25 (50%), CBCT analysis in 27 (54%) and clinical analysis following CBCT and using an operating microscope in 27 (54%) and 29 (58%) teeth, respectively. The use of Start X ultrasonic inserts allowed one to detect two additional teeth with MB2 (62%). According to Vertucci's classification 48% of the mesiobuccal canals found were type I, 28% type II, 18% type IV and 6% type V. Statistical analysis showed no significant differences (p > 0.5) in the ability of CBCT to detect MB2 canals when compared with clinical assessment with or without an operating microscope. A significant difference (p < 0.001)was found only between periapical radiography and clinical/CBCT evaluations.


CONCLUSIONS
Combined use of different methods increased the detection ofthe second canal in MB roots, but without statistical difference among CBCT, operating microscope, Start X and clinical analysis.
Health Division Glòria, City Hall of Joinville, Joinville, SC, Brazil.
Allan
A
Abuabara
Flares
F
Baratto-Filho
Juliana
J
Aguiar Anele
Denise Piotto
DP
Leonardi
Manoel Damião
MD
Sousa-Neto
D000293:Adolescent; D000328:Adult; D000368:Aged; D063405:Anatomic Variation; D016009:Chi-Square Distribution; D002965:Classification; D054893:Cone-Beam Computed Tomography; D003737:Dental Cavity Preparation; D003786:Dental Pulp Cavity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D006801:Humans; D008437:Maxilla; D008853:Microscopy; D008875:Middle Aged; D008963:Molar / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D009811:Odontometry / Q000379:methods; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D014463:Ultrasonography; D055815:Young Adult