Assessment of Mesiobuccal Canal Configuration, Prevalence and Inter-Orifice Distance at Different Root Thirds of Maxillary First Molars: A CBCT Study

Abstract

The aims of this study were to assess the prevalence and configuration of the second mesiobuccal (MB2) canal in the mesiobuccal MB root of permanent maxillary first molars at different root levels in a Saudi sub-population using cone-beam computed tomography (CBCT) and to measure the inter-orifice distance between MB & MB2 at the pulpal floor level. Materials and Methods: This retrospective study was carried out on CBCT images of Saudi patients seen at King Abdul Aziz University. A total of 106 maxillary first molars were evaluated using a specialized software program (iCAT CBCT software). The prevalence of MB2, canal configuration and location of joining (apical-middle-coronal), if present was calculated. Also, the inter-orifice distance between both canals was measured at the level of the pulpal floor. Chi-square and one-way analysis of variance (ANOVA) were used. Results: The MB2 canal was found in 92 (86.8%) maxillary first molar teeth. The MB and MB2 canals were joined in 61 (58%) cases, where the location of joining was 14 (23%), 17 (27%), and 31 (50%) in the coronal, middle, and apical third, respectively. The mean interorifice distance between both canals at the level of the pulpal floor was 2.52±0.76 mm. Conclusion: The prevalence of MB2 canal in this Saudi sub-population was high. The prevalence decreased as the root canal approached the apical third. There was no correlation between the average distance and occurrence of canal joining. CBCT is useful in detecting and mapping the mesiobuccal root canal system, with a likelihood of enhancing the quality of root canal treatment.

Prevalence of Untreated Mesio-Buccal 2 Canal in Maxillary First Molars Reported in KSA Since 2010: A Systematic Review

“…Later that year, in 2019, Fouad Abduljabba et al published a long-term study of the prevalence of Second Mesio Buccal canal in maxillary first molars in the Saudi population, reporting a 20.3 percent incidence of mb2 canals in the right maxillary first molars using cone beam computed tomography in Jeddah [9]. Hadi M et al [10] conducted a study on the root canal morphology of maxillary second molars in a Saudi subpopulation using a Cone Beam computed Tomography in Al-Kharj in 2020, reporting the incidence and prevalence of the four canals in 12 percent (coronal third), 27.6 percent (middle third), and 19.4 percent (lateral third) (apical third). In 2021, Howait M et al [11] conducted a study titled Assessment of Mesio Buccal canal configuration, prevalence, and inter orifice distance at different root thirds of maxillary first molar using CBCT scans in Jeddah among Saudi Sub Populations and published their findings.…”

3D geometric analysis of second mesiobuccal canal in permanent maxillary first molar tooth

“…In endodontics, the axiom 'variation is a norm rather than the exception' is appropriate for the MB2 canal orifice [25]. It varies in its spatial position in relation to the MB and P canal orifices [17,18,20,21] and occurs at varying depths from the pulp floor [5,6]. This is the first CBCT-based study that correlated the depth of the MB2 orifice with IOD (MB-MB2 and MB2-P) and MD.…”

“…Presently, cone-beam computed tomography (CBCT) is the preferred clinical imaging modality for studying root canal anatomy [10][11][12]. Although it has limitations of high radiation exposure, scatter and beam hardening of high-density structures [13], it has been effectively used to locate [14][15][16] and study the anatomical parameters of the MB2 canal [17][18][19][20][21][22][23]. The inter-orifice distance (IOD) [17,18,[20][21][22][23], mesial deviation (MD) [20][21][22] and root canal configuration (RCC) of the mesiobuccal root [17,19] have been extensively investigated on CBCT.…”

“…Although it has limitations of high radiation exposure, scatter and beam hardening of high-density structures [13], it has been effectively used to locate [14][15][16] and study the anatomical parameters of the MB2 canal [17][18][19][20][21][22][23]. The inter-orifice distance (IOD) [17,18,[20][21][22][23], mesial deviation (MD) [20][21][22] and root canal configuration (RCC) of the mesiobuccal root [17,19] have been extensively investigated on CBCT. However, the depth of location of the MB2 orifice was not considered in these studies.…”

Association between second mesiobuccal missed canals and apical periodontitis in maxillary molars of a Chilean subpopulation

“…Upper molars are the most frequently teeth affected by apical periodontitis due to untreated canals ( 12 , 13 ), a cause attributed primarily to missing the second mesiobucal (MB2) canal. The reported prevalence of post-treatment AP associated with untreated MB2 canal is high, varying from 50–90% depending on the affected tooth (first or second molar), and the study methodology ( 10 , 14 - 16 ).…”