Resumo
Objetivo: Avaliar a acurácia da tomografia computadorizada de feixe cônico (TCFC) na detecção do segundo canal mesiobucal (MB2) em primeiros molares superiores. Métodos: Foi realizada uma revisão sistemática de acordo com o PRISMA 2020 e registrada no PROSPERO (CRD420251067699). As buscas foram realizadas no MEDLINE (via PubMed), BVS, LILACS, Cochrane Library e Google Scholar para estudos publicados entre 2013 e 2025. Os estudos elegíveis incluíram ensaios clínicos, estudos observacionais, revisões sistemáticas e meta-análises que avaliaram a TCFC para a detecção do MB2 em primeiros molares superiores. Os critérios de exclusão foram relatos de caso, estudos com animais e modelos experimentais. A extração de dados abrangeu o desenho do estudo, as características da população, os protocolos de imagem e a prevalência do MB2. A certeza da evidência foi avaliada com a abordagem GRADE. Resultados: De 2.502 registros, sete estudos atenderam aos critérios de inclusão. A tomografia computadorizada de feixe cônico (CBCT) demonstrou maior precisão diagnóstica do que as radiografias convencionais, com prevalência de MB2 variando de 69,6% a 92%. Não foram encontradas diferenças significativas entre os molares superiores direito e esquerdo. Os achados referentes a sexo e idade foram inconsistentes, enquanto etnia, classificação de Vertucci e distância interorifícios foram relatados como fatores de influência. A certeza da evidência variou de moderada a alta. Considerações finais: A CBCT é uma ferramenta confiável e precisa para detectar canais MB2 em primeiros molares superiores, aprimorando a capacidade diagnóstica, o planejamento do tratamento e os resultados endodônticos.
Referências
AZIM AA, ALAUGAILY I. Prevalence of MB2 canals in maxillary molars and its subsequent clinical detection using CBCT: a comparative clinical study. J Endod, 2017; 43: 608–12.
ALRAHABI M, ZAFAR MS. Evaluation of root canal morphology of maxillary molars using cone-beam computed tomography. Pak J Med Sci, 2015; 31: 426–30.
ALAÇAM T, et al. Second mesiobuccal canal detection in maxillary first molars using microscopy and ultrasonics. Aust Endod J, 2008; 34: 106–9.
BLANK-GONÇALVES LM, et al. Anatomical configuration of the MB2 canal using high-resolution cone-beam computed tomography. J Endod, 2025; 51: 609–15.
BUHRLEY LJ, et al. Effect of magnification on locating the MB2 canal in maxillary molars. J Endod, 2002; 28: 324–7.
BETANCOURT P, et al. Prevalence and location of the secondary mesiobuccal canal in 1,100 maxillary molars using cone-beam computed tomography. BMC Med Imaging, 2016; 16: 66.
CHOGLE S, et al. The recommendation of cone-beam computed tomography and its effect on endodontic diagnosis and treatment planning. J Endod, 2020; 46: 162–8.
CAPUTO BV, et al. Evaluation of the root canal morphology of molars by using cone-beam computed tomography in a Brazilian population: Part I. J Endod, 2016; 42: 1604–7.
CANDEIRO GT, et al. Internal configuration of maxillary molars in a subpopulation of Brazil's Northeast region: a CBCT analysis. Braz Oral Res, 2019; 33: e082.
COELHO MS, et al. Locating the second mesiobuccal canal in maxillary molars: challenges and solutions. Clin Cosmet Investig Dent, 2018; 10: 195–202.
FERNANDES NA, et al. The prevalence of second canals in the mesiobuccal root of maxillary molars: a cone-beam computed tomography study. Aust Endod J, 2019; 45: 46–50.
GUO J, et al. Evaluation of root and canal morphology of maxillary permanent first molars in a North American population by cone-beam computed tomography. J Endod, 2014; 40: 635–9.
GHOBASHY AM, et al. Evaluation of root and canal morphology of maxillary permanent molars in an Egyptian population by cone-beam computed tomography. J Endod, 2017; 43: 1089–92.
IMURA N, et al. Two canals in mesiobuccal roots of maxillary molars. Int Endod J, 1998; 31: 410–4.
KESKIN C, et al. Mesiobuccal and palatal interorifice distance may predict the presence of the second mesiobuccal canal in maxillary second molars with fused roots. J Endod, 2021; 47: 585–91.
KUMAR R. Report of a rare case: a maxillary first molar with seven canals confirmed with cone-beam computed tomography. Iran Endod J, 2014; 9:153–7.
LEE JH, et al. Mesiobuccal root canal anatomy of Korean maxillary first and second molars by cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2011; 111: 785–91.
MARTINS JNR, et al. Prevalence studies on root canal anatomy using cone-beam computed tomographic imaging: a systematic review. J Endod, 2019; 1: 1–15.
MARTINS JNR, et al. Second mesiobuccal root canal in maxillary molars: a systematic review and meta-analysis of prevalence studies using cone-beam computed tomography. Arch Oral Biol, 2020; 113: 104589.
MARTINS JNR, et al. Worldwide analyses of maxillary first molar second mesiobuccal prevalence: a multicenter cone-beam computed tomographic study. J Endod, 2018; 44: 1641–9.
NASSEH I, AL-RAWI W. Cone beam computed tomography. Dent Clin North Am, 2018; 62: 361–91.
NASCIMENTO EHL, et al. Prevalence of technical errors and periapical lesions in a sample of endodontically treated teeth: a CBCT analysis. Clin Oral Investig, 2018; 22: 2495–503.
PATEL S, et al. Cone-beam computed tomography in endodontics: a review of the literature. Int Endod J, 2019; 52: 1138–52.
PÉREZ-HEREDIA M, et al. Cone-beam computed tomographic study of root anatomy and canal configuration of molars in a Spanish population. J Endod, 2017; 43: 1511–6.
RATANAJIRASUT R, et al. A cone-beam computed tomographic study of root and canal morphology of maxillary first and second permanent molars in a Thai population. J Endod, 2018; 44: 56–61.
SILVA EJ, et al. Evaluation of root canal configuration of maxillary molars in a Brazilian population using cone beam computed tomographic imaging: an in vivo study. J Endod, 2014; 40:173–6.
SMADI L, KHRAISAT A. Detection of a second mesiobuccal canal in the mesiobuccal roots of maxillary first molar teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007; 103: e77–81.
SILVA EJNL, et al. Prevalence of root canal system configurations in the Brazilian population analyzed by cone-beam computed tomography: a systematic review. Rev Port Estomatol Med Dent Cir Maxilofac, 2021; 62:69–80.
STROPKO JJ. Canal morphology of maxillary molars: clinical observations of canal configurations. J Endod, 1999; 25:446–50.
WOLCOTT J, et al. A 5-yr clinical investigation of second mesiobuccal canals in endodontically treated and retreated maxillary molars. J Endod, 2005; 31: 262–4.
ZHUK R, et al. Locating the MB2 canal in relation to MB1 in maxillary first molars using CBCT imaging. Aust Endod J, 2020; 46: 184–90.
ZHENG Q, et al. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. J Endod, 2010; 36: 1480–4.
ZAND V, et al. Root canal morphologies of mesiobuccal roots of maxillary molars using cone-beam computed tomography and periapical radiographic techniques in an Iranian population. J Contemp Dent Pract, 2017; 18: 745–9.
ZHANG Y, et al. Assessment of the second mesiobuccal root canal in maxillary first molars: a cone-beam computed tomographic study. J Endod, 2017; 43: 1990–6.
ZHANG X, et al. Investigating the anatomical relationship between the maxillary molars and the sinus floor in a Chinese population using cone-beam computed tomography. BMC Oral Health, 2019; 19:282.
