Prevalencia del segundo canal en la raíz mesiovestibular de los primeros molares maxilares mediante tomografía computarizada de haz de cono

Abstract

Prevalencia del segundo canal en la raíz mesiovestibular de los primeros molares maxilares mediante tomografía computarizada de haz de cono AVANCES EN ODONTOESTOMATOLOGÍA/ 31 RESUMEN Introducción: La morfología del sistema de canales radiculares es compleja y variable. El primer molar maxilar permanente presenta habitualmente un segundo canal en la raíz mesiobucal (MB2). Su falta de localización y total desbridamiento, es la principal causa de fracaso terapéutico. El objetivo fue determinar la prevalencia in vivo del canal MB2 en la raíz mesiovestibular de primeros molares maxilares mediante tomografía computarizada de haz de cono (TCHC). Material y método: Se examinaron imágenes TCHC de primeros molares maxilares, izquierdos y derechos, en ambos sexos. Se excluyeron las raíces con canales radiculares tratados endodónticamente o con postes, rehabilitados mediante prótesis fija, calcificación de canales, evidencia de radectomía o cirugía periapical. Fueron seleccionadas 32 imágenes TCHC. En todos los casos, se realizó un estudio sistemático de la raíz mesiobucal a través de cortes en el plano axial. Resultados: Se observó una prevalencia del 68,75% del canal MB2. No se encontraron diferencias según sexo o lateralidad. El promedio de edad fue de 25,31 años de edad. Discusión: La alta prevalencia encontrada del canal MB2, debe ser considerada antes de establecer un tratamiento de endodoncia para lograr un resultado óptimo y evitar el fracaso terapéutico. La TCHC es una herramienta útil para su detección, y presenta alta sensibilidad. Palabras clave: Primer molar maxilar permanente, canal secundario, raíz mesiobucal, Tomografía computarizada de haz de cono. SUMMARY Introduction: The morphology of the root canal system is complex and variable. The first permanent maxillary molar has usually a second canal in the mesiobuccal root (MB2). Its location and total lack of debridement, is the leading cause of treatment failure. The objective was to determine in vivo the prevalence of MB2 canal in mesiobuccal root of maxillary first molars using Cone-beam computed tomography (CBCT).

Prevalence and location of the secondary mesiobuccal canal in 1,100 maxillary molars using cone beam computed tomography

“…These results are consistent with those reported by Fogel et al [26] and Betancourt et al [14]. However, Zheng et al [1] and Betancourt et al [12] found no difference. The smaller detection percentage of the MB2 canal in women could be explained by the demineralization and loss of bone mass in adults being three times greater in women [27], which would prevent the correct observation of the canal through computerized tomography due to lack of contrast.…”

“…The results obtained in this study revealed a prevalence of the MB2 canal in 69.81% in the 1MM, similar to that reported with the same diagnostic method by Kim et al (63.59%) [20], Lee et al (70.5%) [15], Betancourt et al (68.75%) [12] and higher than the 52% reported by Zhang et al [3] and the 8.78% by Zheng et al [1]. The MB2 canal in the 2MM was identified in 46.90% of the cases, a percentage similar to the results reported using CBCT by Betancourt et al (48%) [14], Lee et al (42.2%) [15], and higher than the 34.32% by Silva et al [21] and the 22% observed by Zhang et al [3].…”

“…Various studies have suggested the use of CBCT as an in vivo diagnostic method to detect the MB2 canal in maxillary molars [1, 3, 12, 14, 15]. The results obtained in this study revealed a prevalence of the MB2 canal in 69.81% in the 1MM, similar to that reported with the same diagnostic method by Kim et al (63.59%) [20], Lee et al (70.5%) [15], Betancourt et al (68.75%) [12] and higher than the 52% reported by Zhang et al [3] and the 8.78% by Zheng et al [1].…”

“…The percentage of visualization of the MB2 canal varies according to the technique used in each study, including histological sections [5], diaphanization [6], magnifying loupes [7], endodontic surgical microscope [8–10], scanning electron microscope [5], micro-computed tomographic analysis [11], and cone beam computed tomography (CBCT) [1, 3, 4, 12]. …”

“…Several articles [1, 3], [4, 12, 15], have used CBCT to study the morphology of the maxillary molars and to ascertain its ability to visualize the MB2 canal; however, its geometric location has not been examined in depth.…”