Middle mesial canals in mandibular first molars: A micro-CT study in different populations

Versiani, Marco Aurélio; Ordinola‐Zapata, Ronald; Keleş, Ali; Alçin, Hatice; Bramante, Clóvis Monteiro; Pécora, Jesus Djalma; Sousa‐Neto, Manoel Damião

doi:10.1016/j.archoralbio.2015.10.020

Cited by 127 publications

(155 citation statements)

References 31 publications

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“…[5][6][7][8][9][10][11][12][15][16][17][18][19][20][21] The detection of additional canals requires thorough knowledge of root canal morphology and its frequent variations. Careful examination of the pulpal floor, selective troughing, and better visualization through a dental operating microscope are essential for the detection of additional canals in a mandibular first molar.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 The mesial root of mandibular molars often shows an additional canal in the form of MM canal. [5][6][7][8][9][10][11][12] Clinical studies have investigated the incidence of MM canals in mandibular molars. Before the introduction of cone beam computed tomography (CBCT), the incidence of MM canal ranged between 1 and 15%, 5,10,13 whereas a recent study 7 has reported a much higher incidence of 46.2% in mandibular first and second molars.…”

Section: Introductionmentioning

confidence: 99%

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Middle Mesial and Middle Distal Canals in Mandibular First Molar

Jabali

2018

The Journal of Contemporary Dental Practice

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Background: Root canal anatomy is a complex entity. The main objective of root canal treatment is to get rid of the infection and have a good apical and coronal seal with an appropriate filling. Inability to achieve thorough cleaning and shaping followed by three-dimensional obturation of the root canal system usually causes root canal treatment failure. For this reason, clinicians should be aware of these anatomical variations to achieve successful treatment. Aim:The aim of this article is to report on the successful treatment and follow-up of mandibular first molar with additional middle mesial (MM) and middle distal (MD) canals.Case report: A 29-year-old white male patient reported with a complaint of pain in relation with tooth #19. On clinical examination, diagnosis of symptomatic irreversible pulpitis with symptomatic apical periodontitis and condensing osteitis was made and nonsurgical root canal treatment was planned. Initially, two mesial and two distal canals were located, and the patient was planned for the obturation in the second visit. The complaint of mild persistent symptoms gave a possibility of additional canals. Under the dental operating microscope and selective troughing on the floor of the pulp chamber with ultrasonic tips, additional canals were located as MM and MD canals. Conclusion:Leaving some area of the root canal system untreated is found to be one of the main reasons for root canal treatment failure. Dentists should take advantage of new tools, such as dental operating microscope and ultrasonic tips to be able to locate and treat the hidden and unusual anatomy.Clinical significance: Mandibular first molar with six canals is very rare to encounter. Clinician should have a thorough knowledge of these unusual anatomy to avoid treatment failure due to incomplete disinfection of the root canal system.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Middle Mesial and Middle Distal Canals in Mandibular First Molar

Jabali

2018

The Journal of Contemporary Dental Practice

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“…The mesial root of mandibular molars commonly has a mesiobuccal and a mesiolingual canal; however, other anatomical configurations such as the presence of an extra canal, termed middle mesial canal (MMC), have also been reported (1,7,8). Currently, improvements in digital imaging systems and the use of magnification in clinical practice has led to an increased reporting on the incidence of MMCs in mandibular molars (1,8), when compared with previous publications using conventional methodologies.…”

Section: Introductionmentioning

confidence: 96%

“…Currently, improvements in digital imaging systems and the use of magnification in clinical practice has led to an increased reporting on the incidence of MMCs in mandibular molars (1,8), when compared with previous publications using conventional methodologies. This anatomical variation has several endodontic implications.…”

Section: Introductionmentioning

confidence: 99%

“…An understanding of the common and unusual morphology of the root canal system, especially in the apical third, is a fundamental prerequisite for successful root canal treatment (1)(2)(3). Therefore, an overall comprehension of the anatomy of the apical root canal and its variations is necessary to understand the requirements for treatment, to avoid damage to periapical tissues and to ensure adequate disinfection of the canal.…”

Section: Introductionmentioning

confidence: 99%

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Unusual Deviation of the Main Foramen from the Root Apex

et al. 2016

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The relationship of the main foramen to the anatomic root apex has been the subject of several studies. Although they are anatomically close, they rarely coincide, and their distance can vary according to age or tooth type, ranging from 0.2 to 3.0 mm. The aim of this short communication was to evaluate the distance between the main foramen of independent middle mesial canals (MMCs) and the anatomical mesial root apex of mandibular first molars using the micro-computed tomography. Twenty-five mandibular first molars with MMCs were scanned (resolution of 9.9 µm), and the distance from its main foramen to the anatomical apex was evaluated. Overall, the distance ranged from 0.2 to 2.4 mm; however, in 3 specimens the distance was greater than 3 mm. This report demonstrates that the exit of the main foramen of the MMC varies considerably and could approach a substantial distance from the anatomical apex greater than previously reported.

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