الفهرس 
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Abstract
The aim of this study was to detect the canal confluence in a digital periapical radiograph, CBCT and clearing techniques and evaluate the precision of the CBCT and digital periapical radiograph in the detection of confluent canals when compared to clearing technique.
This research was performed on 33 extracted humans first and second mandibular molars. (extracted for periodontal reasons). All specimens were put into a human cadaver’s mandible, and the teeth were installed in the prepared alveolar sockets in the molar region to mimic normal alignment and were held in place by wax. The teeth were scanned by CBCT and digital periapical radiography from 0° and 20°mesial- and distal-tube shifts, then stained and cleared.
Using the receiver operating curve analysis test (MedCalc Software Ltd. Version 20.115), all interpreted data from digital periapical radiography and CBCT were statistically compared with the clearing technique, and the statistical significance was set at (p<0.05). It was found that no substantial difference exists among both CBCT and clearing procedures (p= 0.12), the digital periapical radiograph and clearing technique were significantly different (p <0.001). Overall, sensitivity (0.95) and specificity (0.98) values and the Youden index (0.96) were all higher for CBCT than digital PA scans, the sensitivity was 0.95 for CBCT compared to only 0.63 in the case of digital PA, and specificity was 0.98 for CBCT compared to 0.87 in digital PA. Moreover, there was a statistically significant difference in AUC between digital PA and CBCT (P <0.001) in identifying confluent canals. In the case of mesial canals, AUC was significantly higher for CBCT than digital PA scans (p= 0.005), while no significant difference was detected between both modalities in the case of distal canals (p= 0.39). Meanwhile, the mesial roots in the mandibular first and second molars had the highest percentage of confluence. It was concluded that CBCT is more precise than digital periapical radiograph at identifying confluent canals in mandibular molar teeth. For accurate canal anatomy evaluation, the constraints of digital periapical radiography must be understood.