Restorative Dentistry & Endodontics

Morphological characteristics of the mesiobuccal root in the presence of a second mesiobuccal canal: a micro-CT study: Lucas P. Lopes Rosado, Matheus Lima Oliveira, Karla Rovaris, Deborah Queiroz Freitas, Frederico Sampaio Neves; Restor Dent Endod 2022;47(1):e6. Published online January 18, 2022; DOI: https://doi.org/10.5395/rde.2022.47.e6

Abstract PDF PubReader ePub: Objectives
This study investigated the internal morphology of mesiobuccal (MB) roots of maxillary molars with a second mesiobuccal (MB2) canal.
Materials and Methods
Forty-seven maxillary first or second molars from Brazilians were scanned using micro-computed tomography. The following measurements were obtained from the MB roots: root thickness, root width, and dentin thickness of the buccal aspect of the first mesiobuccal (MB1) canal, between the MB1 and MB2 canals, and the palatal aspect of the MB2 and MB1 canals at 3 mm from the root apex and in the furcation region. For statistical analysis, the Student’s t-test and analysis of variance with the post-hoc Tukey test were used (α = 0.05).
Results
In maxillary molars with an MB2 canal, MB roots were significantly thicker (p = 0.0014) and narrower (p = 0.0016) than in maxillary molars without an MB2 canal. The dentin thickness of the palatal aspect of the MB1 canal was also significantly greater than that of MB roots without an MB2 canal at 3 mm from the root apex (p = 0.0007) and in the furcation region (p < 0.0001). In the furcation region of maxillary molars with an MB2 canal, the dentin thickness between the MB1 and MB2 canals was significantly smaller than that in the buccal and palatal aspects (p < 0.0001).
Conclusions
The internal morphology of MB roots of maxillary molars with an MB2 canal revealed differences in dentin thickness, root diameter, and distance between the canals when compared with maxillary molars without an MB2 canal.

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A cone-beam computed tomography study of the prevalence and location of the second mesiobuccal root canal in maxillary molars: Seong-Ju Lee, Eun-Hye Lee, Se-Hee Park, Kyung-Mo Cho, Jin-Woo Kim; Restor Dent Endod 2020;45(4):e46. Published online September 3, 2020; DOI: https://doi.org/10.5395/rde.2020.45.e46

Abstract PDF PubReader ePub: Objectives
This study aimed to investigate the incidence and location of the second mesiobuccal root (MB2) canal in maxillary molars with the aid of various measuring points and lines using cone-beam computed tomography (CT).
Materials and Methods
A total of 205 images of patients who underwent cone-beam CT examinations between 2011 and 2015 as part of their dental diagnosis and treatment were included. There were 76 images of the maxillary first molar and 135 images of the maxillary second molar. Canal orifices were detected at −1 mm from the top of the pulpal floor on cone-beam CT images. Image assessment was performed by 2 observers in reformatted image planes using software. Assessments included measurement of the distance between the MB1 and MB2 canals, and the angles between the lines connecting the MB1-MB2 and distobuccal (DB)-palatal (P) canals. The data were analyzed using the student's t-test.
Results
The prevalence of the MB2 canal was 86.8% in the first molar and 28.9% in the second molar. The angle between the lines connecting the MB1-MB2 and DB-P canals was 2.3° ± 5.7° in the first molar and −3.95° ± 7.73° in the second molar. The distance between the MB1 and MB2 canals was 2.1 ± 0.44 mm in the first molar and 1.98 ± 0.42 mm in the second molar.
Conclusions
The angles between the lines connecting the MB1-MB2 and DB-P canals was almost parallel. These findings may aid in the prediction of the location of the MB2 canal orifice.

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Dilemmas pertaining to three canals in the mesiobuccal root of a maxillary second molar: a case report: Ankit Arora, Shashi Rashmi Acharya, Muliya Vidya Saraswathi, Padmaja Sharma, Amber Ather; Restor Dent Endod 2013;38(3):172-177. Published online August 23, 2013; DOI: https://doi.org/10.5395/rde.2013.38.3.172

Abstract PDF PubReader ePub: The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for the presence of a third canal. The root canal configuration of 3-2-1 was confirmed for the mesiobuccal root using information gained from clinical, radiographic, and multi-detector computed tomography (MDCT) scan findings. This case demonstrates the need for efforts to locate extra canals in the mesiobuccal root of the maxillary molars as their internal anatomy remains a mystery.

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In-depth morphological study of mesiobuccal root canal systems in maxillary first molars: review: Seok-Woo Chang, Jong-Ki Lee, Yoon Lee, Kee-Yeon Kum; Restor Dent Endod 2013;38(1):2-10. Published online February 26, 2013; DOI: https://doi.org/10.5395/rde.2013.38.1.2

Abstract PDF PubReader ePub: A common failure in endodontic treatment of the permanent maxillary first molars is likely to be caused by an inability to locate, clean, and obturate the second mesiobuccal (MB) canals. Because of the importance of knowledge on these additional canals, there have been numerous studies which investigated the maxillary first molar MB root canal morphology using in vivo and laboratory methods. In this article, the protocols, advantages and disadvantages of various methodologies for in-depth study of maxillary first molar MB root canal morphology were discussed. Furthermore, newly identified configuration types for the establishment of new classification system were suggested based on two image reformatting techniques of micro-computed tomography, which can be useful as a further 'Gold Standard' method for in-depth morphological study of complex root canal systems.

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The canal system in the mesiobuccal root of the maxillary first molar: Dong-Hyun Cho, Ho-Young Choi, Sang-Hyuk Park, Gi-Woon Choi; J Korean Acad Conserv Dent 2003;28(3):232-240. Published online May 31, 2003; DOI: https://doi.org/10.5395/JKACD.2003.28.3.232

Abstract PDF PubReader ePub

This study is to investigate the canal system in the mesiobuccal root of the maxillry first molar.

61 maxillary first molars were randomly selected. Serial transverse sections were made perpendicular to the long axis of the mesiobuccal root. Each section was placed in 3% sodium hypochlorite for 24 hours and rinsed in water and dried. The resected surface was stained with 2% methylene blue dye and examined with stereomicroscope.

Canal configuration analysis showed that 36.1% of the specimen classified as type I, 16.4% as type II, 37.7% as type III and 9.8% as type IV.

Type II canal was merged in one canal within 1 to 4mm of the apex. 40% of type II canal converged at 2mm of the apex.

Type IV canal was divided into two canal within 2 to 4mm of the apex. 66.6% of type IV canal branched off at 2mm of the apex.

None of the sections had more than two main root canal.

48.4% of the sections in 3mm with two canals contained an isthmusand more than 70% with two canals has isthmus at 4 to 5mm sections.

63.9% of the mesiobuccal root of maxillary first molar had two canaland 76.5% of sections with two canals in 5 MM had an isthmus. Because of this complexity the clinician should always search for extra canal carefullyand root canal system, including an isthmus, should be cleaned and shaped completelyand obturated three dimensionally for successful endodontic treatment.

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