الفهرس 
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Abstract
The aim of this study was to compare the efficacy of Cone-beam computed tomography, digital Periapical Radiography, and Dental Microscopic exploration to detect root canal anatomical variations in mandibular premolars in an Egyptian population.
One hundred and eighteen extracted human mandibular first and second premolars mounted in cylindrical acrylic blocks were scanned pre-operatively by SCANORA-3D imaging Cone-beam CT device (SOREDEX, Tuusula, Finland) and SOPIX-2 imaging Periapical Radiography sensor (Acteon, Merignac, France).
Identification of root canal configurations was performed according to Vertucci’s classification in three sequential phases. Phase I: Cone-beam CT and Periapical Radiography images were analyzed by five endodontists blindly and independently. Initial inter-examiner reliability tests were performed between evaluators. Each evaluator viewed and evaluated Cone-beam CT images using OnDemand 3D software (Cyber Med, Korea) and Periapical Radiography images using SOPRO imaging software (Acteon, Merignac, France). Vertucci’s classification of each specimen was recorded for Cone-beam CT and Periapical images analysis. Phase II: A straight-line occlusal access was established in each sample, and root canal anatomy was explored and negotiated under dental microscope (SEILER, Missouri, USA) aided by pre-operative Periapical images only. Only sharp endodontic explorers, hand k-files sizes #6, 8, 10, 15 (Dentsply Maillefer, Ballaigues, Switzerland) and ultrasonic tips (Acteon, Merignac, France) were used in attempts to locate all the canals. Vertucci’s classification of each specimen was recorded. Phase III: Teeth were ground buccolingually (gold standard) using high-speed hand piece and long shank diamond bur until visualizing the canal system.
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Methylene blue dye was used to highlight canal anatomy. Vertucci’s classification of each specimen was recorded.
Data were statistically analyzed, and results showed that, (type-I) was the most prevalent configuration (76.3%), followed by type-V (16.9%) and type-III (5.1%), and only (1.7%) presented three-canals configuration. (95.2%) of canals were considered negotiable. There were statistically significant differences between all the detection methods compared with Sectioning (The gold standard). There were statistically significant differences between Periapical Radiography and all the compared methods, with Periapical Radiography being the least accurate. There was no statistically significant difference between Cone-beam CT and dental microscopic exploration.
It was concluded that, (type-I) was the most prevalent configuration with (76.3%) which conforms with majority of previous studies carried out in different ethnic groups with no significant deviation. Periapical Radiography showed the least accuracy. None of the compared detection methods was as accurate as Sectioning.