How important is it to find the second mesiobuccal canal in maxillary molars?
March 19, 2015
Dr. Rodrigo Cunha from the College of Dentistry at the University of Manitoba explains the importance of finding the second mesiobuccal canal in maxillary molars. If you have any questions, you can either email Dr. Cunha or send an email to oasisdiscussions@cda-adc.ca
Watch the video
Dr. Cunba, thanks for this video. What is the clinical success rate of upper endodontically treated molars with two mb canals having only one canal treated?
What is the percentage of mb2 canals that join the mb1 canal before the apex?
When I first graduated, I was not as successful at finding the fourth canal as I am now as my experience has grown, but my success rate is the same.
I assume because these canals joined and the missed canal gets bypassed.
Good evening,
Thank you for your question!
This is a good point. Not all the MB2 have an independent foramen (especially in Second Maxillary Molars). Spagnuole et al (2012) found that 29.41% of the MB2 were independent from the MB1 canals in First Maxillary Molars. Somma et al (2009) found that the MB2 canal was present in 80% of specimens and was independent in 42% of these cases. When present, the MB2 canal merged with the MB1 canal in 58% of cases. It is noteworthy to state that these authors also found that a single apical foramen was found in 37% of specimens, two apical foramina were present in 23% of the cases, with three or more separate apical foramina occurring in 40% of the specimens. As you can see anatomy varies a lot so it is paramount to negotiate all canals possible.
References:
1-Spagnuolo G, Ametrano G, D’Antò V, Formisano A, Simeone M, Riccitiello F, Amato M, Rengo S. Microcomputed tomography analysis of mesiobuccal orifices and major apical foramen in first maxillary molars.Open Dent J. 2012;6:118-25.
2-Somma F1, Leoni D, Plotino G, Grande NM, Plasschaert A. Root canal morphology of the mesiobuccal root of maxillary first molars: a micro-computed tomographic analysis. Int Endod J. 2009 Feb;42(2):165-74.