Variables That Affect the Ability to Find the Second Mesiobuccal Root Canals in Maxillary Molars

Iran Endod J. 2023;18(4):248-253. doi: 10.22037/iej.v18i4.42260.

Abstract

Introduction: The study aimed to investigate the influence of various factors on the localization of the second mesiobuccal (MB2) canal in maxillary molars, a commonly missed canal during endodontic treatment.

Materials and methods: A comprehensive assessment of maxillary molars treated over three years with a dental operative microscope was conducted. Factors such as patient gender, age, tooth type, pulp status, pre-operative cone-beam computed tomography (CBCT), and treatment modality were examined. Statistical analyses included chi-square and multiple logistic regression.

Results: Among 333 treated maxillary molars, the MB2 canal was identified in 60.1%. The prevalence of MB2 canals was significantly higher in the first molars (72.3%) compared to the second molars (40.2%; P=0.001). Multiple logistic regression models showed that gender, tooth type, and treatment modality emerged as significant determinants of MB2 canal localization: males [odds ratio 3.01(CI 95%:1.71-5.32), P<0.001], first molar tooth [odds ratio 4.26 (CI 95%:2.53-7.18), P<0.001] and secondary endodontic treatment [odds ratio 0.06 (CI 95%: 0.004-0.890), P<0.04].

Conclusions: Patient gender, tooth type, and treatment modality play pivotal roles in the identification of the MB2 canal. Additionally, the availability of pre-operative CBCT imaging was associated with a heightened ability to locate the MB2 canal.

Keywords: CBCT; Cone-beam Computed Tomography; Locating; MB2 Canal; Maxillary Molar; Retreatment.