JOE oct 2012 - In Remembrance of Franklin S. / Weine Canal Configuration in the Mesiobuccal Root of the Maxillary First Molar and Its Endodontic Significance

In Remembrance of Franklin S. Weine

Canal Configuration in the Mesiobuccal Root of the Maxillary First Molar and Its Endodontic Significance

Franklin S. Weine, BS, DDS, MSD,* Harry J. Healey, BA, DDS, MSD,† Harold Gerstein, BS, DDS,‡ and Leonard Evanson, BS, DDS, MS§ 

The ultimate objective of endodontic therapy has been stated to be the obliteration of the

prepared root canal space with an inert material in order to restore the integrity and state of good health of the treated tooth in the dental arch . According to Ingle , the most common cause of endodontic failure is apical percolation, with the largest percentage of cases failing due to incomplete canal obliteration. Other reasons for failure in this category include leaving a canal completely unfilled and inadvertently removing a silver point. Quite often a canal is left unfilled because the operator has failed to recog- nize its presence. Rankine-Wilson and Henry and others  have described the not uncommon finding of a bifurcated canal in mandibular incisors, cuspids, and premolars. Green gave an exhaustive description of the presence of auxiliary and secondary canals among all the teeth in the dental arch. Therefore, it is the obligation of those inter- ested in endodontics to be thoroughly familiar with root canal anatomy, in both normal and abnormal situations, in order to keep this cause of endodontic failure to a minimum. 

In Ingle’s  chart listing the frequency of treatment of teeth, compiled from 1957 to 1962, the maxillary first molar represented 5.45 per cent of endodontic cases. In Weine’s study, however, that tooth represented 31.6 per cent of pulpal exposures. With an increased desire of the patient for tooth retention as well as the availability of improved instruments and techniques, it can be assumed that maxillary first molars will be treated more and more . Also contributing to this frequency is the increasing endodontic-periodontic therapy collaboration, since the maxillary molar is one of the most frequent candidates for root amputation .
We were impressed by the fact that maxillary first molars that did not respond prop- erly to routine surgical and/or nonsurgical treatment were brought to successful conclu- sions by the discovery and treatment of a second mesiobuccal canal. (See case histories.) Therefore, we decided to section the mesiobuccal roots of extracted maxillary first molars to determine canal configuration and the incidence of an additional canal

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