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Root Canal Treatment of the Hidden MB2 canal

September 30, 2015 By Dr Pierre Pizem Leave a Comment

second mesiovestibular pre root canal treatment second mesiovestibular post root canal treatment A second mesiovestibular post root canal treatment B

Patient presented with an acute irreversible pulpitis on this first maxillary molar. Maxillary first molars do have a fourth hidden canal (Second mesiovestibular or MB2) in 92% of the cases. Omitting it may lead to a treatment failure. This difficult to locate canal is commonly found with the help of a microscope.

Operative field observation is enhanced with high magnification and coaxial xenon lamp illumination (Carl Zeiss OPMI PROergo dental operative microscope). Dystrophic calcifications have been removed from pulp chamber with ultrasonic diamond coated tips to locate MB2 canal entry. Lots of chelating agent as well as many stainless steel files are needed to progressively regain patency .

Instrumentation has been performed with Mani stainless K files and ProTaper Universal (Dentsply). Chelator: RC Prep. PUI Irrigation: NaOCl 5%. Ultrasonic tip: BUC One from Spartan. P5 (Dentsply) Sealer used: Pulp Canal Sealer. Obturation technique WVC. X Ray Sensors used:  CareStream Kodak 6100.

Filed Under: General, Dental operating microscope (D.O.M.) assisted R.C.T., Pulp stones (denticles), Striving for second Mesio vestibular (MB2) Tagged With: calcifications, endodontic procedure, Endodontist, Mesiovestibular, Microscope, second mesiovestibular, chelating agent, Protaper, dentsply, diamond coated tips, ultrasonic

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