Abstract
Introduction: Endodontists must have detailed knowledge of the typical anatomy of the dental structure and the atypical forms of external and internal root canals. The first permanent maxillary molar and the second permanent maxillary molar are the teeth with the greatest complexity of root canals, presenting higher rates of endodontic failure. Cone beam computed tomography (CBCT) has made it possible to visualize anatomical structures that are difficult to access in three dimensions, and has become a valuable aid as a complementary examination for endodontic diagnosis and treatment. Objective: This study aimed to address the main considerations and outcomes of clinical studies on the use of cone beam computed tomography in the identification and treatment of second mesiobuccal canals. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from October to November 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 112 articles were found, 14 articles were evaluated in full and 12 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 46 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies did not show homogeneity in their results, with X2=91.5%<50%. Results and Conclusion: It was concluded that endodontic treatment success can be increased and clinicians’ time can be saved by using the newly developed AI-based models to identify variations in root canal anatomy before treatment. Patient gender, tooth type, and treatment modality play essential roles in identifying the MB2 canal. Furthermore, the availability of preoperative CBCT images was associated with a greater ability to localize the MB2 canal. Understanding the incidence of MB2 canals and the distribution pattern of canal orifices in the pulp floor can help clinicians quickly identify and locate MB2 canals.