|
| |
 |
|
| ORIGINAL ARTICLE |
|
| Year : 2022 | Volume
: 9
| Issue : 2 | Page : 45-47 |
|
Frequency of MB2 in maxillary first and second molars in Gujarati population: An in vitro study
Nimisha Chaudhary1, Vaishali Kalburge2, Dharmendra Shah3, Ketan Prajapati4, Malvi Thakkar5, Rohit Thakkar6
1 Tutor, Department of Endodontics, Siddhpur Dental College and Hospital, Dethali, India
2 Assistant Professor, Department of Endodontics, Siddhpur Dental College and Hospital, Dethali, India
3 Dean, Department of Prosthodontics, Siddhpur Dental College and Hospital, Dethali, India
4 Tutor, Department of Oral Pathology, Siddhpur Dental College and Hospital, Dethali, India
5 Senior Lecturer, Department of Orthodontia, Goenka Research Institute of Dental Science, Gandhinagar, Gujarat, India
6 Tutor, Department of Periodontia, Siddhpur Dental College and Hospital, Dethali, India
| Date of Submission | 08-Mar-2022 |
| Date of Acceptance | 22-Apr-2022 |
| Date of Web Publication | 28-Jun-2022 |
Correspondence Address:
Dr. Nimisha Chaudhary
Department of Endodontics, Siddhpur Dental College and Hospital, Sidhhpur, Dethali - 384 151, Gujarat
India
 Source of Support: None, Conflict of Interest: None
DOI: 10.4103/ijpcdr.ijpcdr_8_22
Aim: The aim of this study was to investigate the frequency of second mesiobuccal canal in maxillary first and second molars.
Materials and Methods: Maxillary fifty first molars and fifty second molars were collected and embedded into plaster blocks. The teeth were photographed digitally from the occlusal aspect using a stereomicroscope under standard (×8) magnification. The occlusal portions of crowns were then sectioned at cement–enamel junction with slow-speed diamond disk. To gain straight line visibility, overhung dentin over the canal orifices was removed with safe-tip diamond bur. Once again, the teeth were photographed from their occlusal aspect under the same magnification and exposure conditions.
Results: MB2 canals were detected 76% and 64% in first and second molars, respectively.
Keywords: Maxillary first molar, maxillary second molar, MB2
How to cite this article:
Chaudhary N, Kalburge V, Shah D, Prajapati K, Thakkar M, Thakkar R. Frequency of MB2 in maxillary first and second molars in Gujarati population: An in vitro study. Int J Prev Clin Dent Res 2022;9:45-7 |
How to cite this URL:
Chaudhary N, Kalburge V, Shah D, Prajapati K, Thakkar M, Thakkar R. Frequency of MB2 in maxillary first and second molars in Gujarati population: An in vitro study. Int J Prev Clin Dent Res [serial online] 2022 [cited 2023 Jun 10];9:45-7. Available from: https://www.ijpcdr.org/text.asp?2022/9/2/45/348711 |
| Introduction | |  |
Endodontic success depends to a large extent on thorough cleaning, shaping, and obturation of root canals.[1] It is necessary for the clinician to have a thorough knowledge of the dental anatomy as well as of its variations. The variations in dental anatomy play an important role in the root canal therapy. It is generally accepted that a major cause of the failure of root canal therapy is an inability to localize and treat all of the canals present in teeth.[2],[3]
A major cause of endodontic failure when treating maxillary molars is the inability to locate, debride, or obturate properly second mesiobuccal canal.[4] A statistically significant percentage of failures are related to missed root canals, as these potentially hold tissue, bacteria, and related irritants that inevitably contribute to clinical symptoms and lesions of endodontic origin. In a study, Hoen and Pink screened 1100 failed endodontically treated teeth and reached to a conclusion that the maxillary first molar was the tooth most often retreated, followed by the mandibular first molar. They found out in their investigation that the incidence of missed root or canals of the retreated teeth was 42%.[5]
Many anatomical and clinical studies have shown that there is a higher frequency of two root canal systems within the mesiobuccal root of the maxillary molar than was previously suspected.[6],[7] Weine et al. were among the first to publish a paper on the clinical endodontic significance of locating and treating the second mesiobuccal canal.[8] The routine use of magnification and stains certainly aids in the visualization of anatomic structures and may improve a clinical treatment quality.
The aim of this study was to determine the frequency of second mesiobuccal canal in maxillary first and second molars in Gujarati population.
| Materials and Methods | | |
Periodontally involved, extracted maxillary fifty first molars and fifty second molars were collected from the Oral Surgery Department of Government Dental College and Hospital, Ahmedabad, irrespective of demographics such as age, sex, race, or place. The teeth were rinsed under tap water in order to remove blood and tissue debris. Following removal of all attached soft tissue and calculus using an ultrasonic scaler, radiographs of the teeth were taken so as to exclude those with calcifications in the root canal. The selected teeth (n = 100) were stored in 10% formalin solution at room temperature till used.
The teeth were embedded into plaster blocks with their vertical axes aligned perpendicular to the horizontal plane and four reference marks at 3, 6, 9, and 12 O'clock position made with indelible pencil. The teeth were photographed digitally from the occlusal aspect using a stereomicroscope under standard (×8) magnification. The occlusal portions of crowns were then sectioned at cement–enamel junction (CEJ) with a water-cooled, slow-speed diamond disk. To gain straight line visibility of root canal orifices, overhung dentin over the canal orifices were removed with safe-tip diamond bur. The teeth were immersed in 3% sodium hypochlorite solution for 24 h to facilitate better visualization of canal orifices. The canal orifices were negotiated with a size 10K file. Once again, the teeth were photographed from their occlusal aspect under the same magnification and exposure conditions.
| Results | | |
The frequency of second mesiobuccal canal in maxillary first molars was 76% [Table 1] and [Figure 1] and second molars 64% [Table 2] and [Figure 2]. | Table 1: Number and distribution of canal orifices in maxillary first molar teeth
Click here to view |
 | Table 2: Number and distribution of canal orifices in maxillary second molar teeth
Click here to view |
Overall 38 maxillary first molars had four canal orifices (MB1, MB2, distobuccal, and palatal), while 12 had three orifices (mesiobuccal, distobuccal, and palatal).
In maxillary second molars, one had five (mesiobuccal 1, mesiobuccal 2, distobuccal 1, distobuccal 2, and palatal): 32 had four (mesiobuccal 1, mesiobuccal 2, distobuccal, and palatal) and 17 had three canal orifices (mesiobuccal, distobuccal, and palatal).
| Discussion | | |
A major cause of the failure of root canal therapy is inability to recognize the presence of and to adequately treat all the canals of the root canal system. The frequency and risk of missed canals are linked with the complexity of the root canal system, which is especially true when working on molars. Based on the literature, it is evident that knowledge of the anatomical variations of the maxillary molars is extremely important for the success of endodontic treatment. According to Cohen and Burns, canals are often not treated because they are not located and negotiated.[9]
Without doubt, a proper access cavity preparation is of central importance in locating the orifices of root canals. The conventional access cavity design may not always reflect the anatomy of the pulp chamber floor, hence, in the present study, to achieve the optimal access, teeth were sectioned at CEJ and overhung restrictive dentin was removed to completely reflect the floor anatomy.
The morphology of the mesiobuccal root of maxillary molars has been documented as a complex root canal system with fins, isthmuses, and transverse anastomoses. A second canal in mesiobuccal root in permanent maxillary molars is one of the common variations. In vitro studies have shown that a MB2 canal is present in more than 93% of maxillary first permanent molars and 60% in second molars.[10] This higher incidence of MB2 was due to the use of dental operating microscope. Kulild and Peters utilizing the Dental Operating Microscope (DOM) located two canals in the mesiobuccal root of maxillary molars 95.2% of the time.[11] Baldassari-Cruz et al. demonstrated an increase in the number of second mesiobuccal canals located from 51% with the naked eye to 82% with the DOM.[12] The frequency varies widely depending on the method used, various sectioning techniques, different social groups, different age groups, with or without magnification, etc., Limited access and visibility in a clinical setting as well as the risk of perforation may explain the lower prevalence of MB2 canals as compared with in vitro studies. In this study, the frequency of MB2 in maxillary first and second molars was accordingly 76% and 64% with microscope which is in accordance with the above studies.
| Conclusion | | |
From the results of the present study, we concluded that it is imperative for a clinician performing endodontic therapy on maxillary molars to examine carefully the pulpal floor to locate the orifices of any “extra” canals, especially the second mesiobuccal canal by removing the restrictive dentin over the orifices.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Schilder H. Cleaning and shaping the root canal. Dent Clin North Am 1974;18:269-96.  |
| 2. | Cantatore G, Berutti E, Castellucci A. Missed anatomy: Frequency and clinical impact. Endod Top 2009;15:3-31. |
| 3. | Das S, Warhadpande MM, Redij SA, Jibhkate NG, Sabir H. Frequency of second mesiobuccal canal in permanent maxillary first molars using the operating microscope and selective dentin removal: A clinical study. Contemp Clin Dent 2015;6:74-8. [ PUBMED] [Full text] |
| 4. | Weine FS, Hayami S, Hata G, Toda T. Canal configuration of the mesiobuccal root of the maxillary first molar of a Japanese sub-population. Int Endod J 1999;32:79-87. |
| 5. | Hoen MM, Pink FE. Contemporary endodontic retreatments: An analysis based on clinical treatment findings. J Endod 2002;28:834-6. |
| 6. | Christie WH, Thompson GK. The importance of endodontic access in locating maxillary and mandibular molar canals. Endod J 1994;60:527-36. |
| 7. | Green D. Double canals in single roots. Oral Surg Oral Med Oral Pathol 1973;35:689-96. |
| 8. | Weine FS, Healey HJ, Gerstein H, Evanson L. Canal configuration in the mesiobuccal root of the maxillary first molar and its endodontic significance. Oral Surg Oral Med Oral Pathol 1969;28:419-25. |
| 9. | Cohen S, Burns RC. Pathways of the Pulp. 7 th ed. Missouri: Mosby; 1998. |
| 10. | Stropko JJ. Canal morphology of maxillary molars: Clinical observations of canal configurations. J Endod 1999;25:446-50. |
| 11. | Kulild JC, Peters DD. Incidence and configuration of canal systems in the mesiobuccal root of maxillary first and second molars. J Endod 1990;16:311-7. |
| 12. | Baldassari-Cruz LA, Lilly JP, Rivera EM. The influence of dental operating microscope in locating the mesiolingual canal orifice. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:190-4. |
[Figure 1], [Figure 2]
[Table 1], [Table 2]
|
Search Pubmed for