A study of the distobuccal root canal orifice of the maxillary second molars in Chinese individuals evaluated by cone-beam computed tomography

Xuan Han,Guoju Li,Haibing Yang,Yan Wang,Lin Yang,Cheng Tian

doi:10.1590/s1678-77572012000500012

Abstract

As is commonly understood, the root canal morphology of the maxillary molars is usually complex and variable. It is sometimes difficult to detect the distobuccal root canal orifice of a maxillary second molar with root canal treatment. No literature related to the distobuccal root canals of the maxillary second molars has been published.ObjectiveTo investigate the position of the distobuccal root canal orifice of the maxillary second molars in a Chinese population using cone-beam computed tomography (CBCT). Material and methodsIn total, 816 maxillary second molars from 408 patients were selected from a Chinese population and scanned using CBCT. The following information was recorded: (1) the number of root canals per tooth, (2) the distance between the mesiobuccal and distobuccal root canal orifice (DM), (3) the distance between the palatal and distobuccal root canal orifice (DP), (4) the angle formed by the mesiobuccal, distobuccal and palatal root canal orifices (∠ PDM). DM, DP and ∠ PDM of the teeth with three or four root canals were analyzed and evaluated. ResultsIn total, 763 (93.51%) of 816 maxillary second molars had three or four root canals. The distance between the mesiobuccal and distobuccal orifice was 0.7 to 4.8 mm. 621 (81.39%) of 763 teeth were distributed within 1.5-3.0 mm. The distance between the palatal and distobuccal orifice ranged from 0.8 mm to 6.7 mm; 585 (76.67%) and were distributed within 3.0-5.0 mm. The angle (∠ PDM) ranged from 69. 4º to 174.7º in 708 samples (92.80%), the angle ranged from 90º to 140º. ConclusionsThe position of the distobuccal root canal orifice of the maxillary second molars with 3 or 4 root canals in a Chinese population was complex and variable. Clinicians should have a thorough knowledge of the anatomy of the maxillary second molars.

Highlights

Successful root canal therapy is based on adequate debridement and complete obturation of the root canal system
816 maxillary second molars from 408 patients (181 men, 227 women) with a mean age of 27.3 years (13-57 years) were selected according to the following criteria: (1) maxillary second molar with no caries or defect; (2) no filled materials; (3) no periapical lesions; (4) no root canal treatment; (5) no root canals with open apices, resorption or calcification; and (6) good quality cone-beam computed tomography (CBCT) images
763 (93.51%) subjects had three or four root canals; we evaluated the position of the distobuccal root canal orifice in each

Summary

Introduction

Successful root canal therapy is based on adequate debridement and complete obturation of the root canal system. It is commonly acknowledged that the failure of root canal therapy is caused by the inability to effectively treat all the canals of the root canal system. The root canal morphology of the maxillary molars is usually complex and variable. Countless studies focus on the second mesiobuccal root canal (MB2) because of its frequent involvement. Concerning the second maxillary molar, it is generally accepted that the most common form involves three root canals, while other conditions involve 2 or 4 root canals. Because the position of the maxillary second molars is at or near the end of the dentition, it is difficult to detect all the canals and to subsequently finish the cleaning and obturation.

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