Keywords
Cone-Beam Computed Tomography
Root Canal Therapy
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Abstract
Objective: To evaluate the accuracy of cone-beam computed tomography (CBCT) in detecting second mesiobuccal (MB2) canals in maxillary first molars. Methods: A systematic review was conducted in accordance with PRISMA 2020 and registered in PROSPERO (CRD420251067699). Searches were performed in MEDLINE (via PubMed), BVS, LILACS, Cochrane Library, and Google Scholar for studies published between 2013 and 2025. Eligible studies included clinical trials, observational studies, systematic reviews, and meta-analyses evaluating CBCT for MB2 detection in maxillary first molars. Exclusion criteria were case reports, animal studies, and experimental models. Data extraction covered study design, population characteristics, imaging protocols, and MB2 prevalence. The certainty of evidence was assessed with the GRADE approach. Results: From 2,502 records, seven studies met the inclusion criteria. CBCT showed higher diagnostic accuracy than conventional radiographs, with MB2 prevalence ranging from 69.6% to 92%. No significant differences were found between right and left maxillary molars. Findings regarding sex and age were inconsistent, while ethnicity, Vertucci classifications, and inter-orifice distances were reported as influencing factors. Certainty of Evidence ranged from moderate to high. Final considerations: CBCT is a reliable and accurate tool for detecting MB2 canals in maxillary first molars, improving diagnostic capacity, treatment planning, and endodontic outcomes.
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