NSRCT max molars Flashcards
According to most root anatomy studies, how many roots do the maxillary 1st and 2nd molars have?
The maxillary 1st and 2nd molars most com- monly have three roots, a mesiobuccal root, a distobuccal root, and a palatal root.The internal anatomy of those roots is highly variable, especially in the mesiobuccal root.The mesiobuccal root of maxillary molars tends to have two canals, with maxillary 1st molars tending to have a higher prevalence of two canals in the mesiobuccal root than maxillary 2nd molars (Cleghorn, Christie & Dong 2006).
What is the most common cause for non‐surgical root canal treatment failure of maxillary molars?
The most common cause for non‐surgical root canal failure is failure to locate and treat the second mesiobuccal canal in maxillary 1st and 2nd molars. Studies have shown that failure to locate and properly treat second mesiobuccal canals in maxil- lary molars will affect the long term prognosis and success of these teeth, and will eventually lead to endodontic failure (Wolcott et al. 2005); therefore, it is crucial for the clinician to be knowledgeable and thorough when treating maxillary molars.
What is the average prevalence of a second mesiobuccal canal in maxillary 1st molars? What is the average prevalence of a second mesiobuccal canal in maxillary 2nd molars?
There have been multiple studies that have examined and evaluated the presence of a second mesiobuccal canal in maxillary molars. According to an in vitro study, a second mesiobuccal canal was found in up to 95.2% of both 1st and second maxil- lary molars (Kulild & Peters 1990). Other studies evaluated clinical existence of a second mesiobuccal canal in 1st maxillary molars and found it to be present in 71.2% of the time (Fogel, Peikoff & Christie 1994). Another interesting study, which was conducted over a period of 8 years, found that initially the clinician located a second mesiobuccal canal in 73.2% for 1st molars and 50.7% for 2nd molars. However, when the clinician gained more experience and utilized a dental operating micro- scope, the mesiobuccal canal was found in 93% and 60.4% for 1st and 2nd molars, respectively (Stropko 1999). A more advanced study reviewed 34 studies and weighted the average of a total of 8,399 1st molars, concluding that a second mesiobuccal canal was present in 56.8%.The study further found that the distal root and the palatal root had one canal in 98.3% and 99% respectively (Cleghorn et al. 2006).
What tools can a clinician utilize to locate the second mesiobuccal canal in maxillary molars?
A wise and properly trained clinician would realize that the prevalence of a second mesiobuccal canal is high and should utilize dental technological advancements such as the dental operating micro- scope, piezo ultrasonics, and specialty burs to aid in finding these canals.
