Detection of second mesiobuccal canals in maxillary first molars of the Indian population - a systematic review and meta-analysis.

Objective The aim of this systematic review and meta-analysis was to integrate the detection of second mesiobuccal (MB2) canals in maxillary first molars reported by different studies and methods on the Indian population.Methods This systematic review was conducted following Meta-analysis Of Observational Studies in Epidemiology (MOOSE) and PRISMA guidelines. A comprehensive search was conducted in PubMed, Medline, LILACS, Science Direct, Clinicaltrials.gov, CTRI and Cochrane databases to identify manuscripts published until 20 May 2021. Two independent reviewers assessed eligibility for inclusion, extracted data and assessed quality using the Newcastle-Ottawa Scale for cross-sectional studies.Results The database search identified 534 citations, including 36 citations through manual search, and communications from authors. After removing duplicates and going through 534 abstracts followed by 26 full-text articles, 16 articles met the inclusion criteria and contributed data for the review. The included studies used CBCT, radiographs, direct vision (DV), dental operating microscope (DOM) or dental operating microscope with ultrasonic instrumentation (DOMI) for MB2 detection. Meta-analysis and forest plot showed a pooled prevalence of 64.76% of MB2 canals in permanent maxillary first molars using CBCT, 26.5% for DV, 60.4% for using magnification in addition to DV and 71.9% for DV and magnification assisted with ultrasonic instrumentation. The prevalence of MB2 was found to be more in men than women.Conclusion The pooled prevalence in this systematic review and meta-analysis for detection of MB2 canals using CBCT was 64.76% compared to the global prevalence of 73.8%. Further well-designed studies are required to establish maxillary first molar MB2 prevalence in the Indian population.