Applicability of CBCT as a Substitute for the Gold-Standard Tooth Clearing Technique for Identification of Internal Anatomical Variations of Mandibular Incisors

Knowledge about the root canal system variations is crucial for successful endodontic treatment. This study aimed to examine the applicability of cone-beam computed tomography (CBCT) as a substitute for the gold-standard tooth clearing technique in identification of internal anatomical variations of mandibular incisors.

This in-vitro study evaluated 66 extracted mandibular incisors. The CBCT scans with 0.1 mm voxel size were obtained using NewTom VGO scanner. The number and type of canals, presence/absence of accessory canals, anas-tomosis, apical delta, and morphology of the root apex were all determined. After clearing and staining of the samples, the parameters were re-evaluated under a stereomicroscope for further examination and comparison with the CBCT data. The agreement of the two methods was evaluated by intra-class correlation and Kappa co-efficients for quantitative and qualitative data, respectively.

The results of CBCT assessment were comparable with the gold standard. The most common type of root canal anatomy detected in the central and lateral incisors was the Vertucci’s type I followed by type III. Most apical foramina were buc-cally-deviated and centralized in mesiodistal aspect. CBCT assessment was not valid for assessment of the accessory canals in central incisors and for assessment of mesi-odistal deviation, while an acceptable agreement was noted for the other parameters.

CBCT showed a high accuracy for identification of root canal configuration of mandibular incisors and was comparable with the clearing technique in root canal system assessment; therefore, it can serve as an acceptable substitute for this purpose.