Prevalence of The Second Mesio-buccal Canal and Second Distobuccal Canal in The Maxillary First Molars Among a Sample of Erbil –Kurdistan Region Population Using CBCT
DOI:
https://doi.org/10.15218/edj.2025.15Keywords:
Cone Beam Computed Tomography (CBCT), Maxillary first molar, MB2, Root canal system, Distobuccal canalAbstract
Background and Objectives: Adequate knowledge of anatomic variations in root canal morphology is essential for improving the outcome of root canal treatment. The maxillary first molars commonly require endodontic treatment; however, they are known to have the most complex root canal systems.
Aim: To evaluate the frequency of the second mesiobuccal (MB2) canal and the second distobuccal (DB2) canal in maxillary first molars, as well as the bilateral symmetry of the maxillary first molars (MFM) with the second mesiobuccal canal, and the association of gender and age to their occurrence using cone beam computed tomography (CBCT).
Methods: This retrospective study investigated 140 maxillary first molars from 80 CBCT scans collected from a private dental imaging centre in Hawler over 4 months from May to August 2024. The patients were aged 13 to 57 years (mean age: 29.1 years). Data were analysed using SPSS (version 25) with descriptive statistics and the Chi-Square test.
Results: The prevalence of the MB2 canal in MFM was 53.6%. Both males and females have a similar prevalence of MB2 canals in their MFM. In 75 MFM with MB2 canals, a single apical exit was found in 51.9% of the cases. No significant correlation was found between the prevalence of the MB2 canal and gender or age. In the 41 patients with MB2 canals in their MFM, the likelihood of bilateral MB2 canals was high (82.9%). The frequency distribution of the second distobuccal canal was low (7.9%); however, the age group 21-30 showed the highest occurrence of second distobuccal canals in MFM.
Conclusion: The use of CBCT is a valuable tool in detecting MB2 canals, therefore improving the outcomes of root canal treatment. A high prevalence of MB2 canals was found in the study. The prevalence of bilateral MB2 was high.
References
Dahlström L, Lindwall O, Rystedt H, Reit C. ‘Working in the dark’: Swedish general dental practitioners on the complexity of root canal treatment. Int Endodontics Journal. .2017;50(7):636-45.10.
Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod onticsTopics 2005; 10:3-29.
Cantatore G, Berutti E, Castellucci A. Missed anatomy: frequency and clinical impact. Endod Topics 2009; 15:3-31.
Ingle JI, Bakland L, eds. Endodontics, 5th Edition. Hamilton, Ontario: BC Decker, 2002.
Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod 2006; 32:813-821.
Qun L, Longing N, Qing Y, Yuan L, Jun W, Qingyue D. A case of asymmetric maxillary second molar with double palatal roots. Quintessence Int 2009; 40: 275-276 [PMID: 19417870].
Zhang R, Yang H, Yu X, Wang H, Hu T, Dummer PM. Use of CBCT to identify the morphology of maxillary permanent molar teeth in a Chinese subpopulation. Int Endod J 2011; 44:162-9.
Cleghorn BM, Christie WH, Dong CC.Root and root canal morphology of the human permanent maxillary first molar: A literature review. J Endod 2006; 32:813- 21.4.
Somma F, Leoni D, Plotino G, Grande NM, Plasschaert A. Root canal morphology of the mesiobuccal root of maxillary first molars: a microcomputed tomographic analysis. Int Endod J. 2009;42(2):165–74. 2591.2008.01472.x.
Wen S, Lin Z, Zhu M, Ge J, Wang T. Comparative study of root canal morphology of mandibular incisors by cone-beam CT and canal staining and clearing technique. Prog Geog. 2016;25(1):6–10.
Ren HY, Kum KY, Zhao YS, Yoo YJ, Jeong JS, Perinpanayagam H, Wang XY, Li GJ, Wang F, Fang H, Gu Y. Maxillary molar root and canal morphology of Neolithic and modern Chinese. Arch Oral Biol. 2021; 131:105272.
Mohan RP, Thomas MS, Shetty N, Ahmed J, Pallippurath G, Tallada A. Evaluation of the root and canal morphology of maxillary first and second molar using cone beam computed tomography: A retrospective study. World J Dent. 2017; 8:134 8.
Shetty H, Sontakke S, Karjodkar F, Gupta P, Mandwe A, Banga KS. A Cone Beam Computed Tomography (CBCT) evaluation of MB2 canals in endodontically treated permanent maxillary molars. A retrospective study in Indian population. J Clin Exp Dent. 2017;9: 51–5.
Yu X, Guo B, Li KZ, Zhang R, Tian YY, Wang H, et al. Cone-beam computed tomography study of root and canal morphology of mandibular premolars in a western Chinese population. BMC Med Imaging. 2012; 12:0–4.
Rahman NA, Halim MS, Khamis MF, Ghani HA. Analysis of root and canal morphology of maxillary first and second molars among Malay ethnic in the Malaysian population with the aid of cone-beam computed tomography: A retrospective study. Eur J Gen Dent. 2020;9:84–9.
J.N.R. Martins, D. Marques, E.J.N.L. Silva, J. Caramês, A. Mata, M.A. Versiani Second mesiobuccal root canal in maxillary molars: a systematic review and meta- analysis of prevalence studies using cone- beam computed tomography. Arch Oral Biol journal. 2020;(113), 104589.
Reis AGDAR, Grazziotin-Soares R, Barletta FB, Fontanella VRC, Mahl CRW. Second canal in mesiobuccal root of maxillary molars are correlated with root third and patient age: A cone-beam computed tomographic study. Journal of Endodontics. 2013; 39:588–92.
Al-Habib M, Assessment of mesiobuccal canal configuration, prevalence and inter-orifice distance at different root thirds of maxillary first molars; A cbct study. Clin Cosmet Investing Dent. 2021; 13:105-11.
Betancourt P, Navarro P, Cantín M, Fuentes R. Cone-beam computed tomography study of prevalence and location of MB2 canal in the mesiobuccal root of the maxillary second molar. Int J Clin Exp Med. 2015; 8:9128–34.
H.M. Fogel, M.D. Peikoff, W.H. Christie Canal configuration in the mesiobuccal root of the maxillary first molar: a clinical study. Journal of Endodontics. 1994;20(3): 135-137.
S. Sert, G.S. Bayirli. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish Population. Journal of Endodontics. 2004;30(6): 391-398.
Mohamadamin MT, Thiab KA, Khalid RF, Khidir KM. Detecting second mesiobuccal canal in maxillary first molars in Erbil citizens: CBCT Retrospective study. Erbil Dental Journal .2021;3(2):112-8.
Faraj BM. The frequency of the second mesiobuccal canal in maxillary first molars among a sample of the Kurdistan Region-Iraq population-A retrospective cone-beam computed tomography evaluation. Journal of Dental Science. 2021;16(1):91-95.
Khidir, Hiwa S.; Dizayee, Saud J.; and Ali, Sangar H. Prevalence of Root Canal 17. 17.Configuration of Mandibular Second Molar Using Cone-Beam Computed Tomography in a Sample of Iraqi Patients," Polytechnic Journal.2021;11(1).
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