Detection of the presence of second mesiobuccal canal in the maxillary first molar with bitewing radiography using MediXpar.

BACKGROUND: The second mesiobuccal canal (MB2) variation, which is frequently found especially in maxillary first molars, is a significant cause of complications. The aim of this study was to perform pulp depth analysis of maxillary first molars using bitewing radiographs and to evaluate the role of the MediXpar in the diagnosis of MB2. METHODS: Retrospectively 64 cases (46 patients) in which bitewing radiographs and CBCT were included in the study. CBCT were used as the gold standard for MB2 detection. The MediXpar was used for pulp depth analysis from bitewing radiographs. Four different ROIs created by manual segmentation were determined for pulp depth analysis and pixel count, DATS, PowerDATS and edge density data were recorded for each. RESULTS: No significant difference was detected between molars with MB2 (n=32) and without MB2 (n=32), according to the pixel count, DATS and edge density data obtained from four different ROIs. Significant difference was detected in the PowerDATS results for each ROI, and without MB2 was significantly higher. In the presence of MB2, the ratio of samples with PowerDATS results below 90 was 84%, 78%, 68% and 75% for ROI1, ROI2, ROI3 and ROI4, respectively. In the absence of MB2, the ratio of samples with PowerDATS results above 90 was 59%, 75%, 75% and 75%, respectively. CONCLUSIONS: Bitewing radiographs analysed with the MediXpar can help predict the presence of an MB2 canal. Teeth with an MB2 had notably lower PowerDATS values than those without, indicating this noninvasive analysis may guide the need for confirmatory CBCT.