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Area of Science:

• Dentistry
• Radiology
• Endodontics

Background:

• The second mesiobuccal (MB2) canal in maxillary molars is often missed, impacting endodontic treatment success.
• Cone-beam computed tomography (CBCT) is crucial for detecting complex root canal anatomy, but image quality can be affected by artifacts and settings.

Purpose of the Study:

• To assess the influence of varying tube current and Metal Artifact Reduction (MAR) tool activation on the detection accuracy of the MB2 canal using CBCT.
• To determine optimal CBCT imaging parameters for reliable MB2 canal visualization.

Main Methods:

• Forty maxillary molars (20 with and 20 without MB2 canals, confirmed by micro-CT) were prepared and obturated with a metal post.
• CBCT scans were acquired at different tube currents (4, 6.3, 12.5 mA) with and without MAR activation.
• Diagnostic performance was evaluated by five examiners using ROC analysis, with intra- and interexaminer agreement assessed via Kappa statistics.

Main Results:

• Area under the curve (AUC) values ranged from 0.90 to 0.94, sensitivity from 0.75 to 0.78, and specificity from 0.89 to 0.95.
• No statistically significant differences in MB2 canal detection were found based on variations in tube current or MAR activation.
• Intra- and interexaminer agreement scores indicated moderate to substantial reliability.

Conclusions:

• Tube current and MAR activation do not significantly alter the detectability of the MB2 canal in CBCT imaging.
• Lower tube current settings (e.g., 4 mA) without MAR activation are suggested for MB2 canal detection to optimize the dose-benefit ratio.
• These findings aid in refining CBCT protocols for improved endodontic diagnostics.