CBCT prevalence of MB2 canals in Maxillary molars and its subsequent clinical detection. A comparative clinical study.

Abstract

Objective: The aim of this clinical study was to determine the prevalence of the MB2 canals, factors associated with its radiographic detection using CBCT, and the correlation between CBCT detection and clinically finding these canals. Materials & Methods: All treatments were completed in the endodontic post-graduate clinic using surgical operating microscopes. Information related to the patient’s age, sex, tooth, treatment type, and type of coronal restoration, were recorded. If MB2 canal was located, this information was recorded together with its canal configuration. If CBCT was acquired before or during treatment, the scans were observed by two board-certified endodontists to determine the radiographic presence or absence of MB2. Fleiss’ Kappa analysis was performed to calculate the inter-observer agreement regarding the presence or absence of MB2 on the CBCT scans. Chi-square, Fisher exact test, and binary logistic regression analyses were performed to establish a correlation between the recorded variables and the ability to locate the MB2 canals clinically and radiographically. Results:556 maxillary molar teeth met the inclusion criteria. MB2 canals were located in 68.5%. There was no statistically significant difference in the prevalence of MB2 between cases with and without CBCT scans (P>0.05). There was a higher prevalence of MB2 canals, both clinically and radiographically, in male patients, first molars, and retreatment cases (P<0.05). There was no correlation between the patient’s age and observing the MB2 on the scan (P>0.05), However, patients above 60 yrs. of age had a significantly lower clinical prevalence of MB2 (Odds Ratio:2.83; 95% CI 1.28 - 6.23; P= 0.01). The presence of a full coverage restoration did not affect the clinical or radiographic detection of MB2 (P>0.05). Conclusion: The prevalence of MB2 canals is high among maxillary molar teeth when high magnification is being used, particular among male patients, first molars, and retreatment cases. CBCT has high sensitivity in detecting MB2 canals which can improve the clinician’s certainty to further search for it. However, it did not increase the incidence of locating MB2 canals, particularly in older patients. Clinical Relevance: MB2 canals may be observed on the CBCT but not all of them will be clinically accessible, particularly in older patients.