Dealing with MM canal in a lower first molar
Several studies published in the Literature described the morphology of mandibular first molars, reporting the presence of three or four canals. In 1974, Vertucci and William described the presence of an independent middle mesial canal.
Since then, there have been multiple case reports of aberrant canal morphology of the mandibular first molar, describing aberrant canals in the mesial or even in the distal root.
The middle mesial canal can be independent, mesiolingual confluent or mesiobuccal confluent: the first step to treat it is to determine the location of the mesiolingua canal and the mesiobuccal canal. Then, clean the isthmus area using ultrasonic and heavy irrigation to get a clearer view that makes it easier to pick up the middle canal. In some cases, CBCT can help locating the MM canal.
The clinician should be aware of this varied anatomy in order to manage correctly the case.
A 22-year-old female patient came to the clinic with pain from cold stimulation and percussion.
Pre opertive x-ray showed the abnormal anatomy of the first lower left molar
After caries removal and cleaning pulp chamber.
Cleaning and shaping of middle mesial canal
Checking of W.L and apical control to achieve apical sealing and to avoid over obturation
When checking master Cone, we notice that MMC joins ML and MB canals
Obturation done with BC sealer and Modified Warm Vertical compaction
About the author : Dr Abdulla Alshawi
Graduated from Uruk dental collage-Iraq 2018-2019
Understanding the anatomy of the teeth is the most important point in the treatment of the roots of the teeth, and the things that increase the success rate of endodontic treatments are that you have sufficient knowledge and the required equipment, these factors make endodontic treatment more accessible.
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