|Case of the Month
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July 2002 – Missed MB2 - The Importance of Separate Foramina
July's Case of the Month relates to the classic endodontic referral of failure to heal in the maxillary molar. Very frequently this is due to a "Clean Miss" of the 2nd canal in the Mesio-Buccal root. This canal ( commonly called MB2 or he Mesio-Lingual canal) is one of the most common reasons for failure of treatment. We will examine this case radiographically and give you hints as to how to locate the canal.
When examining the MB root of a maxillary molar, always look to see if the canal is "centered" in the root. (Best determined with a radiograph of a working length file.) If the canal appears to be "off to one side of the root" then the chances are that you have a second canal in this root.
Many of us have been fortunate in the past. The foramina of MB1 and MB2 frequently have a common exit and you may "get lucky" without filling MB2, especially if the amount of pulp tissue in MB2 is small and the case is vital. ( Note: that is NOT an excuse for NOT filling this canal! Its almost always THERE , you just have to find it ) However, when there are two distinct canals, BOTH canals must be found and treated or the case will not heal.