Evaluation of Dentin Thickness around Second Mesiobuccal Canal in Maxillary First Molar Using Cone Beam Computed Tomography (CBCT)

Document Type : Original Article

Authors

1 Department of Endodontics, Dental School, Urmia University of Medical Sciences, Urmia, Iran

2 Dental School, Urmia University of Medical Sciences, Urmia, Iran

Abstract

Background and aim: Maxillary first molars exhibit a variety of anatomies in the mesiobuccal root, with a concavity on the distal wall limiting the canal's preparation to prevent strip perforation. This study evaluated the dentin thickness around the second mesiobuccal canal (MB2) in the maxillary first molar using cone-beam computed tomography (CBCT).
Materials and methods: The present retrospective descriptive cross-sectional study conducted on 120 CBCT images of patients referred to Radiology Centers of Urmia (Iran) between 2017 and 2019. Samples were collected using a convenience sampling method. A professional radiologist prepared all the CBCT images that had the least exposure required with proper image resolution. The first and second mesiobuccal canals (MB1 and MB2) were both detected. Two endodontists evaluated the dentin thickness around the MB2 canal in the mesial, distal, and palatal walls and its distance to MB1 at coronal, middle and apical cross-sections. Statistical significance level set at 0.05 and all analyses performed using SPSS version 23 software.  
Results: In all three sections, the lowest dentin thickness was in the distal wall. The highest was in the palatal wall; this difference was statistically significant in all sections (p<0.05). Minimum distances of MB2 from mesial, distal and furcation surfaces and from MB1 canal were significantly different in coronal (p = 0.008), middle (p = 0.004) and apical (p = 0.001) sections.
Conclusion: The low thickness of distal wall indicates more conservative considerations in endodontic and prosthodontic treatments. The CBCT seems to be an effective and non-invasive method in examining root and canal morphology. It may be used as preoperative radiography to assess the dentin thickness in danger zones to prevent iatrogenic errors.

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  1. Rezaeian M, Tonekaboni MR, Iranmanesh F. Evaluating the root canal morphology of permanent maxillary first molars in Iranian population. Iranian endodontic journal. 2018;13(1):78.
  2. Ahmed HM, Versiani MA, De-Deus G, Dummer PM. New Proposal for Classifying Root and Root Canal Morphology. In the Root Canal Anatomy in Permanent Dentition: Springer; 2019. p. 47-56.
  3. Lewis AB, Garn SM. The relationship between tooth formation and other maturational factors. The Angle Orthodontist. 1960;30(2):70-7.
  4. Ghasemi N, Rahimi S, Shahi S, Samiei M, Reyhani MF, Ranjkesh B. A review on root anatomy and canal configuration of the maxillary second molars. Iranian endodontic journal. 2017;12(1):1.
  5. Liu D, Qiu L, Yu J. A Rare Root Canal Configuration of a Maxillary Second Molar with Fused C-shaped Buccal Root and Five Canals: A Case Report and Review of literature. Iranian Endodontic Journal. 2019;14(3):225-31.
  6. Khademi A, Naser AZ, Bahreinian Z, Mehdizadeh M, Najarian M, Khazaei S. Root morphology and canal configuration of first and second maxillary molars in a selected Iranian population: A cone-beam computed tomography evaluation. Iranian endodontic journal. 2017;12(3):288.
  7. Hargreaves KM, Berman LH. Cohen's pathways of the pulp expert consult: Elsevier Health Sciences; 2015.
  8. Degerness RA, Bowles WR. Dimension, anatomy and morphology of the mesiobuccal root canal system in maxillary molars. Journal of endodontics. 2010;36(6):985-9.
  9. Neelakantan P, Subbarao C, Subbarao CV. Comparative evaluation of modified canal staining and clearing technique, cone-beam computed tomography, peripheral quantitative computed tomography, spiral computed tomography, and plain and contrast edium–enhanced digital radiography in studying root canal morphology. Journal of endodontics. 2010 Sep 1;36(9):1547-51.
  10. Nair R, Khasnis S, Patil JD. Permanent maxillary first molar with three mesiobuccal canals. Indian Journal of Dental Research. 2019 Nov 1;30(6):975.
  11. Shahravan A, Rekabi A, Shahabi H, Ashuri R, Mirzazadeh A, Rad M, Haghani J. A digital stereomicroscopic study of the furcation wall thickness of mesiobuccal roots of maxillary first and second molars. Iranian endodontic journal. 2010;5(2):88.
  12. Mathew T, Shetty A, Hegde MN, Babu B, Shetty KS. Study of the morphology of MB2 canals in maxillary first molars using CBCT. Indian Journal of Public Health Research & Development. 2018;9(5):359-62.
  13. Kosaraju D, Garlapati R, Bolla N, Potru LB, Billa M. Prevalence of MB2 Canals in Maxillary Second and First Molars in Coastal Andhra Population-A Cone Beam Computed Tomography Study. JIDA: Journal of Indian Dental Association. 2018 Nov 1;12(11).
  14. Yamaguchi M, Noiri Y, Itoh Y, Komichi S, Yagi K, Uemura R, Naruse H, Matsui S, Kuriki N, Hayashi M, Ebisu S. Factors that cause endodontic failures in general practices in Japan. BMC oral health. 2018 Dec 1;18(1):70.
  15. Alrahabi M, Zafar MS. Evaluation of root canal morphology of maxillary molars using cone beam computed tomography. Pakistan journal of medical sciences. 2015;31(2):426.
  16. Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. Journal of endodontics. 2006;32(9):813-21.

 

  1. Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S. Clinical investigation of second mesiobuccal canals in endodontically treated and retreated maxillary molars. Journal of endodontics. 2002;28(6):477-9.
  2. American Dental Association Council on Scientific Affairs. The use of cone-beam computed tomography in dentistry: an advisory statement from the American Dental Association Council on Scientific Affairs. The Journal of the American Dental Association. 2012 Aug 1;143(8):899-902.
  3. Estrela C, Holland R, Estrela CR, Alencar AH, Sousa-Neto MD, Pécora JD. Characterization of successful root canal treatment. Brazilian dental journal. 2014 Feb;25(1):3-11.
  4. Al-Shahrani SM, Al-Sudani D, Almalik M, Gambarini G, AlRumaihi FA. Microcomputed tomographic analysis of the furcation grooves of maxillary first premolars. Annali di stomatologia. 2013;4(1):142.
  5. Abuabara A, Baratto-Filho F, Aguiar anele J, Leonardi DP, Sousa-Neto MD. Efficacy of clinical and radiological methods to identify second mesiobuccal canals in maxillary first molars. Acta Odontologica Scandinavica. 2013;71(1):205-9.
  6. Blattner TC, George N, Lee CC, Kumar V, Yelton CD. Efficacy of cone-beam computed tomography as a modality to accurately identify the presence of second mesiobuccal canals in maxillary first and second molars: a pilot study. Journal of endodontics. 2010;36(5):867-70.
  7. Betancourt P, Navarro P, Fuentes R. CBCT technique for location of the MB2 canal of maxillary first molar. 2017.
  8. Zhang Y, Xu H, Wang D, Gu Y, Wang J, Tu S, Qiu X, Zhang F, Luo Y, Xu S, Bai J. Assessment of the second mesiobuccal root canal in maxillary first molars: a cone-beam computed tomographic study. Journal of endodontics. 2017 Dec 1;43(12):1990-6.
  9. Chai H, Tamse A. Vertical root fracture in buccal roots of bifurcated maxillary premolars from condensation of gutta-percha. Journal of endodontics. 2018;44(7):1159-63.
  10. Lammertyn PA, Rodrigo SB, Brunotto M, Crosa M. Furcation groove of maxillary first premolar, thickness, and dentin structures. Journal of endodontics. 2009;35(6):814-7.