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Could cone-beam computed tomography demonstrate the lateral accessory canals?

Yan Ji1, Shanhui Wen2, Shu Liu2

  • 1Department of Preventive Dentistry, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China.

BMC Oral Health
|December 1, 2017
PubMed
Summary

Cone-beam computed tomography (CBCT) in high-resolution (HZ) mode effectively evaluates mandibular incisor root canal morphology, including lateral and accessory canals (LACs). While HZ mode offers superior diagnostic detail, the increased radiation dose requires careful consideration.

Keywords:
Canal staining and tooth clearing techniqueCone-beam computed tomographyMandibular incisorRadiation doseRadiographyRoot canal morphologyVoxel size

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Area of Science:

  • Dentistry
  • Radiology
  • Endodontics

Background:

  • Cone-beam computed tomography (CBCT) is increasingly used for root canal morphology assessment.
  • Few studies have evaluated CBCT's efficacy in detecting tiny lateral and accessory canals (LACs).

Purpose of the Study:

  • To assess the capability of CBCT in evaluating mandibular incisor root canal morphology across three scanning settings.
  • To compare CBCT's performance against the canal staining and tooth clearing (CS) gold standard technique.

Main Methods:

  • 70 extracted mandibular incisors were scanned using CBCT at high-resolution (HZ), zoom (ZS), and full (FS) modes.
  • Radiologists and endodontists evaluated root canal number, configuration (Vertucci's classification), and LACs, comparing results with CS.
  • Statistical analysis included chi-square tests and Kappa statistics for intra- and inter-evaluator agreement.

Main Results:

  • High-resolution (HZ) mode, despite higher radiation dose, demonstrated superior accuracy for evaluating root canal configuration and detecting LACs.
  • Diagnostic accuracy for root canal number exceeded 90% across all modes.
  • Intra-evaluator agreement was excellent; inter-evaluator agreement was excellent for canal number and configuration but variable for LACs.

Conclusions:

  • The high-resolution (HZ) mode is recommended for comprehensive root canal system evaluation, including partial detection of LACs.
  • The diagnostic benefits of HZ mode must be balanced against the increased radiation exposure.
  • Further research may be needed to optimize LAC detection with CBCT.