• Restorative Dentistry and Endodontics
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• 제47권1호
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• pp.6.1-6.9
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• 2022

Objectives: This study investigated the internal morphology of mesiobuccal (MB) roots of maxillary molars with a second mesiobuccal (MB2) canal. Materials and Methods: Forty-seven maxillary first or second molars from Brazilians were scanned using micro-computed tomography. The following measurements were obtained from the MB roots: root thickness, root width, and dentin thickness of the buccal aspect of the first mesiobuccal (MB1) canal, between the MB1 and MB2 canals, and the palatal aspect of the MB2 and MB1 canals at 3 mm from the root apex and in the furcation region. For statistical analysis, the Student's t-test and analysis of variance with the post-hoc Tukey test were used (α = 0.05). Results: In maxillary molars with an MB2 canal, MB roots were significantly thicker (p = 0.0014) and narrower (p = 0.0016) than in maxillary molars without an MB2 canal. The dentin thickness of the palatal aspect of the MB1 canal was also significantly greater than that of MB roots without an MB2 canal at 3 mm from the root apex (p = 0.0007) and in the furcation region (p < 0.0001). In the furcation region of maxillary molars with an MB2 canal, the dentin thickness between the MB1 and MB2 canals was significantly smaller than that in the buccal and palatal aspects (p < 0.0001). Conclusions: The internal morphology of MB roots of maxillary molars with an MB2 canal revealed differences in dentin thickness, root diameter, and distance between the canals when compared with maxillary molars without an MB2 canal.

• Restorative Dentistry and Endodontics
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• 제38권3호
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• pp.172-177
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• 2013

The mesiobuccal root of the maxillary molars is well known to pose a hindrance during endodontic therapy. Presented here is a case of a maxillary left second molar where three canals were located in its mesiobuccal root with the use of visual and diagnostic aids. Difficulties encountered during the process of unveiling the tooth's internal anatomy were discussed. The dilemmas encountered pertained to the root canal configuration, the nomenclature of the extra canals, and the justification for the presence of a third canal. The root canal configuration of 3-2-1 was confirmed for the mesiobuccal root using information gained from clinical, radiographic, and multidetector computed tomography (MDCT) scan findings. This case demonstrates the need for efforts to locate extra canals in the mesiobuccal root of the maxillary molars as their internal anatomy remains a mystery.

• Restorative Dentistry and Endodontics
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• 제47권4호
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• pp.37.1-37.9
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• 2022

Objectives: This study aimed to evaluate the prevalence of apical periodontitis (AP) in the mesiobuccal roots of root canal-treated maxillary molars. Materials and Methods: One thousand cone-beam computed tomography images of the teeth were examined by 2 dental specialists in oral radiology and endodontics. The internal anatomy of the roots, Vertucci's classification, quality of root canal treatment, and presence of missed canals were evaluated; additionally, the correlation between these variables and AP was ascertained. Results: A total of 1,000 roots (692 first molars and 308 second molars) encompassing 1,549 canals were assessed, and the quality of the root canal filling in the majority (56.9%) of the canals was satisfactory. AP was observed in 54.4% of the teeth. A mesiolingual canal in the mesiobuccal root (MB2 canal) was observed in 54.9% of the images, and the majority (83.5%) of these canals were not filled. Significant associations were observed between the presence of an MB2 canal and the quality of the root canal filling and the presence of AP. Conclusions: AP was detected in more than half of the images. The MB2 canals were frequently missed or poorly filled.

• 대한치과의사협회지
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• 제58권10호
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• pp.604-614
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• 2020

Objective: The purpose of this study was to analyze the Cone-beam computed tomograghy(CBCT) scan of endodontically treated maxillary first molars and investigate how second mesiobuccal (MB2) canal is treated, how the prognosis of mesiobuccal (MB) root is different compared to other roots and the prognosis factor on apical periodontitis. Methods: Subjects were endodontically treated maxillary first molars whose were collected from CBCT scans taken from January 2018 until December 2019. A total of 525 maxillary first molars were analyzed by an endodontist to determine the presence of the MB2 canal, the quality of the root canal filling, and the presence of apical periodontitis. The chi square test and Fisher's exact test was used to examine the relationship between each variable. Results: MB2 canals were found in 46.3%, of which 76.5% were not treated. The more main canal of mesiobuccal root (MB1 canal) was well filled, the more significantly MB2 canal was well filled (p<0.001). The apical periodontitis of MB root was not related to the filling quality of MB1 canal (p=0.370) and was related to the filling quality of MB2 canal (p=0.004). The apical periodontitis of MB root was related to the quality of canal filling of MB2 canal and the apical periodontitis of DB and P root. Conclusions: It was found that the majority of MB2 canals were not treated. The apical periodontitis of MB root was analyzed to be related to the quality of canal filling of MB2 canal. The apical lesion of the MB root was not correlated with the treatment of the MB1 canal, but it was significantly related to the quality of filling of MB2 canal.

• Restorative Dentistry and Endodontics
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• 제45권4호
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• pp.46.1-46.8
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• 2020

Objectives: This study aimed to investigate the incidence and location of the second mesiobuccal root (MB2) canal in maxillary molars with the aid of various measuring points and lines using cone-beam computed tomography (CT). Materials and Methods: A total of 205 images of patients who underwent cone-beam CT examinations between 2011 and 2015 as part of their dental diagnosis and treatment were included. There were 76 images of the maxillary first molar and 135 images of the maxillary second molar. Canal orifices were detected at -1 mm from the top of the pulpal floor on cone-beam CT images. Image assessment was performed by 2 observers in reformatted image planes using software. Assessments included measurement of the distance between the MB1 and MB2 canals, and the angles between the lines connecting the MB1-MB2 and distobuccal (DB)-palatal (P) canals. The data were analyzed using the student's t-test. Results: The prevalence of the MB2 canal was 86.8% in the first molar and 28.9% in the second molar. The angle between the lines connecting the MB1-MB2 and DB-P canals was 2.3° ± 5.7° in the first molar and -3.95° ± 7.73° in the second molar. The distance between the MB1 and MB2 canals was 2.1 ± 0.44 mm in the first molar and 1.98 ± 0.42 mm in the second molar. Conclusions: The angles between the lines connecting the MB1-MB2 and DB-P canals was almost parallel. These findings may aid in the prediction of the location of the MB2 canal orifice.

• Restorative Dentistry and Endodontics
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• 제38권1호
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• pp.2-10
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• 2013

A common failure in endodontic treatment of the permanent maxillary first molars is likely to be caused by an inability to locate, clean, and obturate the second mesiobuccal (MB) canals. Because of the importance of knowledge on these additional canals, there have been numerous studies which investigated the maxillary first molar MB root canal morphology using in vivo and laboratory methods. In this article, the protocols, advantages and disadvantages of various methodologies for in-depth study of maxillary first molar MB root canal morphology were discussed. Furthermore, newly identified configuration types for the establishment of new classification system were suggested based on two image reformatting techniques of micro-computed tomography, which can be useful as a further 'Gold Standard' method for in-depth morphological study of complex root canal systems.

• Restorative Dentistry and Endodontics
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• 제6권1호
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• pp.83-86
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• 1980

Fifty human maxillary second molars were injected with china ink, decalcified, cleared, and used in vitro study to determine the number of root canals, the frequency and location of lateral canals, canals per root, and frequency of apical deltas. The results were as follows. 1. The mesiobuccal root was found to contain a single primary canal in 62% of the teeth studied and two canals in 38% of the teeth studied. 2. In mesiobuccal roots with two canals, the seperated apical foramen appeared 24% of the specimens and the common apical foramen 14% of the specimens. 3. Of the 169 canals studied, 23.1% of the canals were found to contain lateral canals and these ramifications were mainly located in the apical third of the root.

• Restorative Dentistry and Endodontics
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• 제40권2호
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• pp.161-165
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• 2015

Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

• 대한치과보철학회지
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• 제58권2호
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• pp.95-102
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• 2020

목적: Cone-beam computed tomographic (CBCT)를 이용하여 한국인의 상악 제1대구치(MM1), 제2대구치(MM2)에서 제2근심협측(MB2) 근관, 치근 융합 및 C형 근관의 발생률에 대해 평가하였다. 재료 및 방법: 술 전 평가를 위해 CBCT 촬영을 한 환자를 선택했다. 1658명의 환자로부터 1498개의 MM1과 1742개의 MM2의 CBCT 영상이 획득되었고, MB2 근관, 치근융합 및 C형 근관을 분석했다. 연령, 성별 및 치아위치와 MB2 근관 발생률간의 관계도 조사하였다. 결과: 연구표본은 비교적 고령(평균연령: 66.1세)이었다. MB2 근관의 발생률은 MM1, MM2 각각 60.1%, 28.0% 였고, MM1, MM2에서 각각 Weine Type III, Type II가 우세했다. 연령이 증가함에 따라 MB2 근관은 감소하는 경향을 보였으며, MM1에서는 남성에서 MB2 근관이 더 많이 발견되었다. 치근융합은 MM1에서 2.3%, MM2에서 26.2%, C형 근관은 MM1에서 0.4%, MM2에서 2.7%로 모두 MM2에서 발생률이 더 높았다. 결론: MB2 근관은 MM2보다 MM1에서 더 발생률이 높았다. 치근융합과 C형 근관은 모두 MM2에서 더 발생률이 높았다.

• 대한소아치과학회지
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• 제29권2호
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• pp.139-145
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• 2002

유치에서는 영구치에 비해 법랑질의 두께가 얇고 약하며 상대적으로 큰 치수강으로 인하여 단시간에 치아우식증이 치수까지 이환되며, 외상 또는 치과치료 중 갑작스런 움직임으로 인하여 치수가 노출되는 경우가 빈번하다. 이러한 이유로 어린이에서의 치수처치는 필수적이며, 유치에서 치수치료의 목적은 감염된 치수조직을 제거하여 동통을 완화시키는 것 이외에도 크게는 치열궁을 보존하여 저작기능을 보호하고, 미래의 영구치열이 적절한 교합관계를 이루게 하는데 있다. 유치열에서 성공적인 치수치료를 위해서는 유치 치수의 형태, 유치 근관의 해부학적 형태, 치근형성, 그리고 유치 치근의 흡수와 관련된 특별한 문제점들에 대한 이해를 필요로 한다. 상악 대구치와 마찬가지로 상악 유구치의 근심 치근이 형태에 있어서 가장 큰 변이를 보인다고 알려져 있으며, 이 치근 내에 존재하는 모든 근관을 처치하지 못한다면 결국 치수치료는 실패할 것이다. 본 증례는 근관치료 중이거나 후에 지속적인 동통이나 근관 내 출혈이 지속되는 경우에서 상악 유구치의 근심협측치근의 제 2근심협측근관을 발견하고 처치한 후 임상증상 및 동통이 사라지고, 양호한 예후를 보였다. 또한 발거된 상악 유구치를 대상으로 한 조사 결과 상악 제 1유구치는 35개 증 8개(22.8%), 상악 제 2유구치는 33개 중 22개(66.6%)의 치아에서 제 2근심협측근관이 발견되었으며. 이는 상악 유구치의 근심협측치근 내에 두 개의 근관이 존재할 가능성이 높다는 것을 의미한다.