Influence of the Intracanal Material and Metal Artifact Reduction Tool in the Detection of the Second Mesiobuccal Canal in Cone-beam Computed Tomographic Examinations

Introduction: The aim of this study was to evaluate the influence of different intracanal materials and the metallic artifact reduction (MAR) tool of cone-beam computed tomographic (CBCT) imaging on the detection of the second mesiobuccal (MB2) canal in maxillary first molars. Methods: Forty maxillary first molars were selected; half of them had the MB2 canal in the mesiobuccal root confirmed by micro-computed tomographic imaging. All teeth were instrumented, except for the MB2 canal, and filled with gutta-percha, which was passively inserted up to the working length. Each tooth was individually inserted into a dry human skull, and CBCT scans were performed using the OP300 device (Instrumentarium Dental, Tuusula, Finland) with and without the use of the MAR tool. For each scanned tooth, the following intracanal materials were used in the palatal root: gutta-percha, silver palladium, nickel chromium, and cobalt chromium. Five examiners assessed the images for the detection of the MB2 canal using a 5-point scale. The weighted kappa test was applied to evaluate intra- and interexaminer reproducibility. The diagnostic values (sensitivity, specificity, and area under the receiver operating characteristic curve) were calculated in the different groups and compared using 2-way analysis of variance and the Tukey post hoc test. Results: The intra- and interobserver agreement ranges for the different conditions were studied. The diagnostic values were not significantly different (P>.05) regardless of the intracanal material and the use of the MAR tool. Conclusions: The presence of different intracanal materials and MAR activation does not influence CBCT-based detection of MB2 canals.