Diagnostic accuracy of two cone-beam computed tomography systems for detection of strip perforation in the mesial root of mandibular molars

Aim: This study aimed to compare the diagnostic accuracy of two cone-beam computed tomography (CBCT) systems for detection of strip perforation in the mesiobuccal canal of mandibular molars after root canal treatment. Methodology: The curved mesiobuccal canals of mandibular first and second molars were instrumented as part of endodontic treatment. The canals were strip-perforated using #2 and #3 Gates-Glidden drills in distoaxial direction at 1 to 3 mm distance from the furcation. The canals were filled with gutta-percha and AH26 sealer with lateral compaction technique. The teeth were then mounted in dry bovine mandible and underwent CBCT using Acteon and NewTom CBCT systems. The CBCT scans were evaluated by two observers, and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of the two CBCT systems for detection of strip perforation were determined and compared. Results: The sensitivity and specificity for detection of strip perforation were 51.3% and 46.3% for Acteon, and 55% and 38.8% for NewTom CBCT system, respectively. The difference between the two CBCT systems for detection of strip perforation was not significant (Chi-square test, P>0.05). Conclusions: The accuracy of Acteon and NewTom CBCT systems for detection of strip perforation is low, and no significant difference was noted between the two systems in this respect.