Cone-beam and micro-computed tomography for the assessment of root canal morphology: a systematic review

A critical analysis of laboratory and clinical research methods to study root and canal anatomy

“…Compared to the staining and clearing method, one study reported that CBCT is as accurate as staining and clearing in studying root and canal anatomy in several tooth types (Neelakantan et al, 2010b); others found that both methods were not able to detect complex canal anatomy (Ordinola‐Zapata et al, 2017), and CBCT was not able to detect accessory canals (Naseri et al, 2019). A number of studies have compared the accuracy of CBCT with micro‐CT; the results revealed that, despite the higher accuracy compared with 2D radiographic imaging, CBCT was less accurate than micro‐CT in detecting complex canal anatomy (Sousa et al, 2017; Zhang et al, 2017a), single oval canals (Paes da Silva Ramos Fernandes et al, 2014), apical canal isthmuses (Tolentino et al, 2018) and apical deltas (Nascimento et al, 2019), consistent with results of a recent systematic review (Borges et al, 2020) (Figure 15). Apart from comparative studies with other diagnostic methods, CBCT has also been used as the diagnostic tool for the study of root canal anatomy including root canal configurations, merging and splitting levels of canals and other landmarks related to the shape of root canal orifices obtained from axial sections (Jain et al, 2017; Neelakantan et al, 2010a; Saber et al, 2019).…”

Prevalence and morphology of C‐shaped and non‐C‐shaped root canal systems in mandibular second molars

“…The current methodology is validated by studies using micro-CT as the reference standard that confirmed the efficacy of CBCT with voxel resolutions up to 250 lm in the detection of the number and configuration of main canals. 4,24 Conversely, even in idealized laboratory settings, CBCT does not appear to provide sufficient detail of complex anatomical configurations and fine structures such as fins, transverse anastomoses, isthmuses, lateral and accessory canals and apical deltas. 25,26 This limitation may be compounded clinically where the final resolution and image quality are affected by patient movement and various other artefacts.…”

Accuracy of periapical and panoramic radiography for detection of root morphologies: a comparative study

“…2,4,11 Moreover, radiographic exposures with LCPAs after a DPT has already been obtained needs justification, as patients should be exposed to the least amount of radiation whilst obtaining the maximum information for diagnosis. Since cone-beam computed tomography is commonly used in the specialist practice setting, 26,27 comparative studies to assess the accuracy for the diagnosis of deviant root morphologies of this imaging technique should be considered in future.…”