Romanian Journal of Oral Rehabilitation (Oct 2023)
PREVALENCE AND ANATOMICAL PARTICULARITIES OF THE SECOND MESIOBUCCAL CANAL OF THE PERMANENT UPPER FIRST MOLAR IN THE ROMANIAN POPULATION IN A CLINICAL ENVIRONMENT USING CONE BEAM COMPUTED TOMOGRAPHIC IMAGING- IN VIVO STUDY
Abstract
One of the most common causes of endodontic treatment failure is inadequate diagnosis and treatment planning of the treated tooth, including lack of comprehensive knowledge about the morphological characteristics and their frequent variations of the entire root canal system. Therefore, a successful root canal treatment depends on a clinician’s ability to locate, clean, shape, and fill the entire canal system in all dimensions. The permanent upper first molar (MFM) is the earliest permanent tooth that appears in the oral cavity and that makes it vulnerable to caries and further to the need of endodontic treatment.Permanent maxillary first molars (MFM) generally have three roots with additional canal located in the mesiobuccal root (MB) which are called first mesiobuccal (MB1) and second mesiobuccal (MB2) and loops, intercanal connections, auxiliary canals, and apical ramifications are all common anatomical features. In maxillary molars, a conventional intraoral periapical radiograph provides a 2D view of the root canal system (RCS); as a result, the prevalence of undetected MB2 canal is high; the need for a 3D view of the RCS can be satisfactorily fulfilled by cone-beam CT (CBCT). The prevalence of MB2 has been assessed in several in vitro and in vivo studies, presenting variations according to the methodology applied, along with the population of interest. As a novelty this study aims to analyze the MB2 canal prevalence, anatomy and working length in MFM in the Romanian population using CBCT imaging and clinical notes. In addition, the data obtained will contribute to the currently available evidence in the literature from other parts of the world as well as increase the general dental practitioners (GDP) awareness about the anatomical complexities and variations of the permanent upper first molar. In this retrospective study, CBCT images and clinical notes of 289 patients with ages between 14 and 78 years old presenting 336 upper first molar pathology were reviewed in this study, which was conducted at the Endodontology Department of the Faculty of Dentistry, University of Medicine and Pharmacy Craiova. According to this retrospective study, the romanian people have a high prevalence of the MB2 canal in permanent maxillary first molar regardless of gender. The overall prevalence of the MB2 canal was 75%, with a type II morphology according to Vertucci classification in 69% of cases and an average length of 14.7mm for type II respectively 18.3 mm for type IV canal type.
