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

Background and Aim: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.