Med. Forum, Vol. 31, No.

2 71 February, 2020

Frequency of Second Mesiobuccal Maxillary

Original Article Mb2 Canal in
Molar

(Mb2) Canal in Maxillary First Permanent Molar

Faisal Nawaz Khan1, Abdul Rehman1, Dilawar Sultan2, Beenish Abbas3,
Hafiz Rabbi-ul-Ehsan1 and Atikah Sagheer3
ABSTRACT
Objective: To examine the frequency of MB2 canals in maxillary first permanent molars.
Study Design: Cross sectional study.
Place and Duration of Study: This study was conducted at the Military Dental Centre, CMH Peshawar from April
2019 to September 2019.
Patients and Methods: Two hundred and thirty eight cases were included. Rubber dam for isolation was applied
after achieving local anaesthesia. MB2 canal location was done in three stages.
Results: There were 65.1% males while 34.9% patients were females with mean age 31.12±11.74 years. Second
mesiobuccal canal was found in 193 cases (81.1%).
Conclusion: The frequency of second mesiobuccal canal was high and the majority of second mesiobuccal canal
openings were located distal to the main mesiobuccal canal.
Key Words: Frequency, MB2 canals, Permanent maxillary first molar
Citation of article: Khan FN, Rehman A, Sultan D, Abbas B, Ehsan FR, Sagheer A. Frequency of Second
Mesiobuccal (Mb2) Canal in Maxillary First Permanent Molar. Med Forum 2020;31(2):71-73.

INTRODUCTION therapy. In these teeth, use of microscope and ultrasonic

tip is essential as these devices are very helpful in
Worldwide most of the root canal treatments are detecting MB2 canal orifices since they provide good
performed in the permanent first molar teeth, because visibility, access and can generate a deeper trough in
these are one of the first teeth to erupt into the oral the dentin on pulp chamber floor.6 Many of the studies
cavity.1 For successful root canal treatment, complete reported that diagnosis of MB2 canal with aid of CBCT
and accurate examination of internal and external tooth (cone-beam computed tomography) is very useful and
morphology is basic pre-requisite requirement.2 incidence rate varies between 48% to 97.6%.7 A study
Unsuccessful debacle of whole root canal system is the was conducted by Khalid al Fouzan8 regarding
most important cause of endodontic failure in first
frequency of MB2 canals in maxillary first and second
permanent molars. It usually happens due to clinician’s
negligence to detect additional root canals.3 In molars and they reported the incidence of MB2 canals
maxillary first permanent molars, the number of canals as 97% and 93% respectively in which they used micro
and roots may vary. Maxillary first molars have three computed tomography for the detection of MB2 canals.
roots and 3 to 4 canals and the 4th canal being a 2nd Globally the frequency rate of MB2 canals is reported
mesio-buccal canal. The frequency of MB2 canal is 73.8% and diagnosis made by using CBCT.9 Multiple
reported to be 56.8% to 80.9.4 MB2 is located 1-3 mm studies have been conducted to examine the frequency
toward the palatal canal from the main/larger mesio- of mesiobuccal root of maxillary molars by using
buccal canal MB.5 It is not so easy to diagnose MB2 micro-CT and reported this device is very useful and
orifice, so clinicians have to use microscope effective for detection of this accessory root and
and ultrasonic toughing when performing root canal canal.10
1.
Department of Dental Center, Military Dental Center, MATERIALS AND METHODS
Peshawar.
2.
Department of Operative Dentistry, Akhtar Saeed Medical This cross sectional study was conducted at Military
& Dental College Lahore. Dental Centre, CMH Peshawar from 1st April 2019 to
3.
Department of Operative Dentistry, Foundation University 30th September 2019. Two hundred and thirty eight
College of Dentistry Islamabad. patients (238) were included in study. Patients having
Correspondence: Dr. Faisal Nawaz Khan, Consultant Dental pulpal exposure and requiring root canal treatment in
Surgeon, 30 Military Dental Center Peshawar. maxillary first permanent molars, both genders between
Contact No: 0322-8235555 15-60 years, and belonging to different races were
Email: [email protected] included. Patients with maxillofacial surgery, patients
having teeth with insufficient periodontal support,
Received: October, 2019 calcified canals, and caries extending to the floor of the
Accepted: December, 2019
pulp chamber were excluded. The patients clinically
Printed: February, 2020
diagnosed with irreversible pulpitis, necrosed pulp and
Med. Forum, Vol. 31, No. 2 72 February, 2020
fulfilling inclusion criteria were selected. Detailed configuration and the frequency of mesiobuccal second
medical and dental histories were taken. Patient’s canal reported majority of patients 56%were males.
demographic and clinical observations were recorded. The current study showed that the prevalence of MB2
Cross infection control measures were taken. Pulp canal was 81.1%. These results were similar to the
chamber floor was carefully inspected by preparing the study conducted by Burhley et al17 but higher than that
access cavity. Rubber dam for isolation was applied reported by Badole et al.18 Another study done by
after giving local anaesthesia. MB2 canal location was Tayfun et al19 regarding frequency of MB2 canal in the
done in three stages. Data was entered and analyzed maxillary first second and third molars was done using
using SPSS 20. microscope and ultrasonic tip for troughing. They
reported the incidence rate of MB2 canal 62%, 67% and
RESULTS 74% respectively.
Atif et al16 reported that the incidence rate of MB2
The mean age of patients in our study was 31.12±11.74
canal was 45%. Another study conducted by
years with 155 (65.1%) were male while remaining 83
Vasundhara et al20 regarding frequency of MB2 canal in
(34.9%) were female (Tables 1-2). Second mesiobuccal
maxillary first permanent molars and they reported
canal was found in 193 cases (81.1%) [Table 3].
68.3% prevalence of MB2 canal. They reported CBCT
Table No.1: Age-wise distribution (n=238) was the most useful and effective method in detection
Age (years) No. % of MB2 canals.
15-20 57 23.9 Das et al21 reported that patients with age group 18 to
21-30 70 29.4 25 years had prevalence of 74% MB2 canals, age group
31-40 56 23.5 26 to 35 years had 73% and the age group 36 to 45
41-50 38 16.0 years had 68% prevalence of MB2 canals. They also
51-60 17 7.2 reported that operating under microscope along with
Mean±SD 31.12±11.74 adjunctive aids showed better results in detecting MB2
canals in maxillary first and second permanent molars.
Table No.2: Gender-wise distribution (n=238)
Gender No. % CONCLUSION
Male 155 65.1
Frequency of MB2canals in maxillary first permanent
Female 83 34.9
molars was found in 81.1%. Majority of the MB2 canal
orifices originate distal to the main MB canal and most
Table No.3: Distribution of cases by second of the MB2 canal orifices are palatal to main MB canal.
mesiobuccal canal (n=238) Author’s Contribution:
MB2 No. % Concept & Design of Study: Faisal Nawaz Khan
Yes 193 81.1 Drafting: Abdul Rehman, Dilawar
No 45 18.9 Sultan
Data Analysis: Beenish Abbas, Hafiz
DISCUSSION Rabbi-ul-Ehsan, Atikah
The present study conducted was aimed to examine the Sagheer
frequency of MB2 canals in maxillary first permanent Revisiting Critically: Faisal Nawaz Khan,
maxillary molars. In this regard we included 238 Abdul Rehman
patients. In the present study, we found that 23.9% Final Approval of version: Faisal Nawaz Khan
patients were ages 15 to 20 years, 29.4% patients had Conflict of Interest: The study has no conflict of
ages 21 to 30 years, 23.5% were ages 31 to 40 years, interest to declare by any author.
16% patients were ages 41 to 50 years and 7.2%
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