Brazil CBCT study - 86-91% MB2 PROVIDED dealing with a three rooted molar Reis JOE 2013
Table 1. The Total Number of Teeth, Teeth with 3 Roots, and the Presence/Absence of MB2 Canals in 3-rooted First and Second Maxillary Molars
|Teeth with 3 roots|
|Right maxillary first molars||79||79||68 (86.1)||11 (13.9)|
|Left maxillary first molars||79||78||71 (91.0)||7 (8.9)|
|Right maxillary second molars||94||88||77 (87.5)||11 (12.5)|
|Left maxillary second molars||91||87||69 (79.3)||18 (20.6)|
|Total||343||332||285 (85.8)||47 (14.1)|
Table 2. The Prevalence of MB2 Canals According to Root Third Assuming have an MB2 (obviously)
|Right maxillary first molars||68 (100)||65 (95.6)||53 (77.9)|
|Left maxillary first molars||71 (100)||68 (95.8)||54 (76.0)|
|Right maxillary second molars||77 (100)||75 (97.4)||51 (66.2)|
|Left maxillary second molars||69 (100)||64 (92.7)||47 (68.1)|
Degerness JOE 2010 - 8x scope 80% MB2 and 1% MB3 more of an isthmus study
|This and the following photo are why I think there is so much variance in % of MB2 "found" in studies. Is it a fin, an isthmus, or an MB2?|
von Arx Int Endo J 2005 76% two canals and isthmus, 10% two canals no isthmus, 14% one canal
In vivo study 1987 77% MB2 and 3% MB3 - Also has great definition of what they consider an MB2
|So are the first and third ones MB2? or figure eight shaped single canals?|
Almeida AGD GD March 2015 case study of 8 POentry and appears to be 6 POE
Jordan study 63% under 3.5x and 57% naked eye. They also state in this study that max first molars have highest failure rate. I am of opinion this is low as 3.5x is not a high mag. I use 6x for everything and have used 2.5, 18.104.22.168, and 6.0 in my career and can say that the jump from 3.5 to 4.5 made a difference for me. Here is a study proving increase in mag increases ability to locate MB2.
Endo program 70% - The results of this study demonstrate that it is imperative for any dentist performing root canal therapy on maxillary first molars to examine carefully the pulpal floor to locate all canals, especially the second mesiobuccal canal.
Coronal half microscope 1990 95% - 54% accessed with hand instruments, 32% with "bur" (seems something similar to munce) and 10% with scope. Shows better techniques and equipment result in more found
Stropko JOE 1999 Clinical 1096 conventionally treated maxillary molars. MB2 73% separate canal in 55%. However, as the operator became more experienced, scheduled sufficient clinical time, routinely employed the dental operating microscope, and used specific instruments adapted for microendodontics, MB2 canals were located in 93.0% of first molars and 60.4% in second molars.
Multiple methods 2009 67% have MB2 and of those 65.30% exhibited 1 foramen
Korean Population CBCT study 64% MB2 1.25% DB2 .25% single root and fused .73% Kim JOE 2012
Hartwell and Bellizzi in vivo 1982 "A discrepancy was observed when 4 canal maxillary molar obturation was compared with the in vitro studies. Access prep should be reevaluated to facilitate the search and location of the 4th canal in maxillary molars. It is almost axiomatic to accept the fact the root canal system of the MB root of the max molars frequently have more than one canal." BINGO!!!
Silva JOE 2014 - Brazil CBCT 314 teeth 3 roots 3 canals 53%, 3 roots 2 MB canals 43%, 2 roots with 1 canal in mesial and 2 canals in distal 3% and 1% reverse of that. Interestingly, .65% 3 separate 2 canals in palatal