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  • Writer's pictureDr Changjie Guo

Challenge of root canal treatment

Root canal anatomy variations present a constant challenge in successful diagnosis and endodontic treatment, especially the multirooted teeth. The most challenging root for endodontic treatment at the level of location, shaping, avoidance of iatrogenic events, and obturation is the fourth (MB2) canal of the upper first molars. Maxillary first molar is the most commonly treated tooth yet with the highest endodontic failure rate because of undetected canals, especially the mesiobuccal second canal (MB2).

In this case, MB2 was successfully detected, shaped and cleaned. All four canals were ready for root filling (obturation).

Maxillary first molar with MB2

Obturation of root canals were completed under dental operating microscope (DOM).

Upper first molar with MB2


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