Introduction: successful root canal therapy should access, shape and clean the complex root canal system in a three-dimensional manner without missing any anatomical variations. Recent advancements in the radiographic imaging technology and the visual aids have enabled the precise detection of extra canals.
Objectives: To detect the presence of middle mesial canals (MM) in permanent mandibular molars using CBCT versus the DOM.
Methodology: One hundred extracted permanent mandibular molars were collected and preoperative CBCT scans were done for all teeth. Digital periapical radiographs and conventional access cavities were done to all teeth. Initial scouting of mesial canals and the number of orifices found in the mesial roots was recorded. Access cavities were rechecked and additional canal scouting using ultrasonics in teeth in which the MM canals were not found was done. All teeth were checked under the DOM for detection and search of the MM canals, if not found in the previous stages. The CBCT taken previously were checked. Recording the presence of MM canals according to CBCT readings. Readings from CBCT and DOM were compared.
Results: The DOM identified MM canals in 41teeth and CBCT detected MM canals in only 14 teeth. The weighted Kappa value was 0.38 (95% CI: 0.22-0.54), indicating fair agreement between the two methods. CBCT demonstrated a sensitivity of 34.15% and a specificity of 100%. Overall accuracy of CBCT in detecting MM canals was 73%.
Conclusions: The DOM is more accurate than cone-beam computed tomography in detecting the presence of MM canals in mandibular molars.