title: Comparative accuracy of the Clearing Technique, CBCT and Micro-CT methods in studying the mesial root canal configuration of mandibular first molars.
abstract: OBJECTIVE
  To compare the accuracy of the clearing technique and cone beam computed tomography (CBCT) in the assessment of root canal configurations using micro-computed tomography (micro-CT) imaging system as the reference standard.
  
  
  METHODS
  Thirty-two mesial roots of mandibular first molars, selected on the basis of micro-CT scans (voxel size: 19.6 μm) and presenting several canal configurations, were evaluated using 2 CBCT scanners (voxels sizes: 120 μm and 150 μm) followed by the clearing technique. Two examiners analysed the data from each method and classified the anatomical configuration of the mesial canal according to Vertucci's system. Data were compared using Fisher's exact and chi-square tests. Reliability for each assessment was verified by the kappa test, and significance level was set at 5%.
  
  
  RESULTS
  Kappa value indicated a high level of agreement between the examiners. Detection of type I configurations was significantly lower in cleared teeth (P < 0.05), whilst type II root canals were detected in all specimens by both tests (P > 0.05). In mesial roots with variable anatomical configurations, CBCT and the clearing method were significantly less accurate than the reference standard (P < 0.05).
  
  
  CONCLUSIONS
  Within the tooth population studied, accuracy of identifying mesial root canal configuration was influenced greatly by the evaluation method and the type of anatomy. Detection of type I configurations in cleared teeth was significantly lower, whilst type II configurations were detected in all specimens by both methods. In mesial roots with variable anatomical configurations, neither CBCT nor clearing methods were accurate for detecting the actual root canal anatomy.
authors.affiliation: Department of Endodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.|Advanced Education in General Dentistry Program, Larkin Community Hospital, Miami, FL, USA.
authors.forename: R
authors.identifier: http://orcid.org/0000-0001-9738-0828
authors.initials: R
authors.lastname: Ordinola-Zapata
authors.affiliation: Department of Endodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.
authors.forename: C M
authors.initials: CM
authors.lastname: Bramante
authors.affiliation: Department of Endodontics, Ribeirão Preto Dental School, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: M A
authors.initials: MA
authors.lastname: Versiani
authors.affiliation: Advanced Education in General Dentistry Program, Larkin Community Hospital, Miami, FL, USA.
authors.forename: B I
authors.initials: BI
authors.lastname: Moldauer
authors.affiliation: Department of Endodontics, Universitat Internacional de Cataluña, Barcelona, Spain.
authors.forename: G
authors.initials: G
authors.lastname: Topham
authors.affiliation: Department of Endodontics, Baylor College of Dentistry, Texas A&M University System Health Science Center, Dallas, TX, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Gutmann
authors.affiliation: Department of Endodontics, Universitat Internacional de Cataluña, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Nuñez
authors.affiliation: Department of Endodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.
authors.forename: M A Hungaro
authors.initials: MA
authors.lastname: Duarte
authors.affiliation: Department of Endodontics, Universitat Internacional de Cataluña, Barcelona, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Abella
mesh_terms: D054893:Cone-Beam Computed Tomography; D003786:Dental Pulp Cavity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D006801:Humans; D008334:Mandible; D008963:Molar / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D018915:Root Canal Preparation / Q000379:methods*; D014092:Tooth Root / Q000033:anatomy & histology* / Q000000981:diagnostic imaging*; D055114:X-Ray Microtomography
keywords: cone beam computed tomography; dental anatomy; mandibular molars; microcomputed tomography