TOMOGRAPHIC ANALYSIS OF THE APICAL TERMINATIONS OF THE MV1 AND MV2 CANALS IN MAXILLARY MOLARS
DOI:
https://doi.org/10.56238/arev8n1-134Keywords:
Cone-Beam Computed Tomography, Tooth Root, Diagnostic ImagingAbstract
This technical report aimed to demonstrate, through cone beam computed tomography (CBCT) images, the two main patterns of apical termination of the mesiobuccal canals (MV1 and MV2) in maxillary molars, correlating the tomographic findings with an illustrative anatomical diagram. Two CBCT scans of maxillary molars with periapical lesions of pulpal origin causing oroantral communication were qualitatively analyzed, selected according to the apical termination pattern of the mesiobuccal canals. The cases were classified into two distinct configurations: apical confluence between the MV1 and MV2 canals, resulting in a single apical foramen; and independent apical termination, with separate apical foramina. Image evaluation was performed in the axial, transverse, and buccopalatal planes, allowing the tracking of the canal paths from the cervical third to the apical third of the mesiobuccal root. The analysis focused on the morphological characterization of the canals and the apical relationship pattern between MV1 and MV2, with subsequent correlation to an illustrative anatomical diagram. Tomographic analysis revealed two distinct patterns of apical termination. In Case 1, the MV1 and MV2 canals showed progressive convergence in the apical third, culminating in the formation of a single apical foramen. In contrast, Case 2 demonstrated two canals with completely independent paths along the entire root length, resulting in separate apical foramina. In both cases, periapical changes associated with the mesial root were observed. The findings demonstrated the anatomical variability of the mesiobuccal root of maxillary molars. Cone beam computed tomography proved to be a relevant complementary tool for identifying apical termination patterns, contributing to a more accurate diagnosis and more predictable and effective planning of endodontic treatment in teeth with complex anatomy.
Downloads
References
1. BARATTO FILHO, F. et al. Analysis of the internal anatomy of maxillary first molars by using different methods. J Endod, v. 35, n. 3, p. 337-342, 2009. DOI: https://doi.org/10.1016/j.joen.2008.11.022
2. BLATTNER, T. C. et al. 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. J Endod, v. 36, n. 5, p. 867-870, 2010. DOI: https://doi.org/10.1016/j.joen.2009.12.023
3. CAMARGO DOS SANTOS, B. et al. Mesiobuccal root canal morphology of maxillary first molars in a Brazilian sub-population: a micro-CT study. Eur Endod J, v. 5, n. 2, p. 105-111, 2020. DOI: https://doi.org/10.14744/eej.2020.29291
4. DO, S.; SEO, M. S. The effect of different confluence confirmation strategies on the obturation of Vertucci type II canal: micro-CT analysis. Restor Dent Endod, v. 46, n. 1, p. e12, 2021. DOI: https://doi.org/10.5395/rde.2021.46.e12
5. DURACK, C.; PATEL, S. Cone beam computed tomography in endodontics. Braz Dent J, v. 23, n. 3, p. 179-191, 2012. DOI: https://doi.org/10.1590/S0103-64402012000300001
6. DZANKOVIC, A. et al. Endodontic challenges arising from root canal morphology. In: Dentistry. London: IntechOpen, 2024. Disponível em: doi.org. Acesso em: 21 jan. 2026. DOI: https://doi.org/10.5772/intechopen.1007288
7. KIM, Y. et al. Morphology of maxillary first and second molars analyzed by cone-beam computed tomography in a Korean population: variations in the number of roots and canals and the incidence of fusion. J Endod, v. 38, n. 8, p. 1063-1068, 2012. DOI: https://doi.org/10.1016/j.joen.2012.04.025
8. MARTINS, J. N. R. et al. Second mesiobuccal root canal in maxillary molars: a systematic review and meta-analysis of prevalence studies using cone-beam computed tomography. Arch Oral Biol, v. 113, p. 104589, 2020. DOI: https://doi.org/10.1016/j.archoralbio.2019.104589
9. NG, Y. L. et al. Outcome of primary root canal treatment: systematic review of the literature. Part 2: influence of clinical factors. Int Endod J, v. 41, n. 1, p. 6-31, 2008. DOI: https://doi.org/10.1111/j.1365-2591.2007.01323.x
10. PATEL, S. et al. European Society of Endodontology position statement: the use of CBCT in endodontics. Int Endod J, v. 47, n. 6, p. 502-504, 2014. DOI: https://doi.org/10.1111/iej.12267
11. PATEL, S. et al. Cone beam computed tomography in endodontics: a review. Int Endod J, v. 48, n. 1, p. 3-15, 2015. DOI: https://doi.org/10.1111/iej.12270
12. REIS, A. G. et al. Second canal in mesiobuccal root of maxillary molars is correlated with root third and patient age: a cone-beam computed tomographic study. J Endod, v. 39, n. 5, p. 588-592, 2013. DOI: https://doi.org/10.1016/j.joen.2013.01.003
13. SILVA, E. J. N. L. et al. Evaluation of root canal configuration of maxillary molars in Brazilian population using cone-beam computed tomographic imaging: an in vivo study. J Endod, v. 40, n. 2, p. 173-176, 2014. DOI: https://doi.org/10.1016/j.joen.2013.10.002
14. VERTUCCI, F. J. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol, v. 58, n. 5, p. 589-599, 1984. DOI: https://doi.org/10.1016/0030-4220(84)90085-9
15. ZHENG, Q. et al. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. J Endod, v. 36, n. 9, p. 1480-1484, 2010. DOI: https://doi.org/10.1016/j.joen.2010.06.018
