title: Detection of various anatomic patterns of root canals in mandibular incisors using digital periapical radiography, 3 cone-beam computed tomographic scanners, and micro-computed tomographic imaging.
abstract: BACKGROUND
  The purpose of this study was to compare the accuracy of digital periapical (PA) radiography and 3 cone-beam computed tomographic (CBCT) scanners in the identification of various internal anatomic patterns in mandibular incisors.
  
  
  METHODS
  Forty mandibular incisors were scanned using micro-computed tomographic imaging as the gold standard to establish the internal anatomic pattern. The number of root canals and internal patterns were classified into type I (single canal, n = 12), type Ia (single oval canal, n = 12), and type III (2 canals, n = 16). The teeth were placed in a human mandible, and digital PA radiography and 3 CBCT scans (Kodak 9000 3D [Carestream Health, Rochester, NY], Veraviewepocs 3De [J Morita MFG Corp, Kyoto, Japan], NewTom 5G [QR Srl, Verona, Italy]) were performed. Two blinded examiners classified each tooth's anatomic pattern, which were then compared with the micro-computed tomographic determinations.
  
  
  RESULTS
  Considering type I and type Ia, which both presented with 1 root canal, there was a high degree of accuracy for all methods used (P > .05). The same result was found for type III. When identifying the shape of single canals (type I), CBCT imaging was more accurate compared with PA radiography. Concerning oval canals (type Ia), there was a significant difference between PA radiography and NewTom CBCT (PA radiography = 44%, NewTom = 88%). However, there were no significant differences between the 3 CBCT units.
  
  
  CONCLUSIONS
  Double-exposure digital PA radiography for mandibular incisors is sufficient for the identification of the number of root canals. All CBCT devices showed improved accuracy in the identification of single root canal anatomy when a narrow canal was present. However, the identification of oval canals was improved only with the NewTom CBCT device.
authors: Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil. Electronic address: lucianamfernandes@usp.br.
authors: Luciana Maria
authors: LM
authors: Paes da Silva Ramos Fernandes
authors: Department of Oral Diagnosis, Radiology, and Pathology (ODRP), Loma Linda University School of Dentistry, Loma Linda, California.
authors: Dwight
authors: D
authors: Rice
authors: (†)Department of Endodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
authors: Ronald
authors: R
authors: Ordinola-Zapata
authors: Department of Stomatology, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
authors: Ana Lucia
authors: AL
authors: Alvares Capelozza
authors: (†)Department of Endodontics, Bauru School of Dentistry, University of São Paulo, Bauru, São Paulo, Brazil.
authors: Clovis Monteiro
authors: CM
authors: Bramante
authors: Department of Endodontics, Loma Linda University School of Dentistry, Loma Linda, California.
authors: David
authors: D
authors: Jaramillo
authors: Department of Oral Diagnosis, Radiology, and Pathology (ODRP), Loma Linda University School of Dentistry, Loma Linda, California.
authors: Heidi
authors: H
authors: Christensen
mesh_terms: D063405:Anatomic Variation; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation / Q000706:statistics & numerical data*; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D007180:Incisor / Q000000981:diagnostic imaging*; D008334:Mandible / Q000000981:diagnostic imaging; D016300:Radiography, Bitewing / Q000706:statistics & numerical data*; D019252:Radiography, Dental, Digital / Q000706:statistics & numerical data*; D015898:Tomography Scanners, X-Ray Computed
keywords: Cone-beam computed tomographic imaging; dental anatomy; digital periapical radiography; mandibular incisors; micro–computed tomographic imaging; root canal morphology