Location of the ML Canal in Maxillary Molars - PowerPoint PPT Presentation

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Location of the ML Canal in Maxillary Molars

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Location of the ML Canal in Maxillary Molars Eric M. Rivera, DDS, MS Diplomate, American Board of Endodontics Introduction The goals of non surgical root canal ... – PowerPoint PPT presentation

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Date added: 2 July 2019
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Title: Location of the ML Canal in Maxillary Molars


1
Location of the ML Canal in Maxillary Molars
  • Eric M. Rivera, DDS, MS
  • Diplomate, American Board of Endodontics

2
Introduction
  • The goals of non surgical root canal therapy are
    to remove debris, prepare and obturate canals.
  • This is mostly contingent on the ability of the
    clinician to locate the canals successfully.

3
Introduction
  • An inherent difficulty in treatment of the
    maxillary molar has been location of the mesial
    lingual canal in the mesial buccal root.

4
of Time That ML Canal Is Located
5
of Time That ML Canal Is Located
  • The ML canal occurs in approximately
  • 60 of Maxillary First Molars
  • 30 of Maxillary Second Molars
  • Approximately 50 of the existing ML canals are
    negotiable, and therefore treatable.

6
of Time That ML Canal Is Located
Mesiolingual canal location, in vitro
53-90
Gilles J, Reader A. 1990 Bjorndal A, Skidmore A.
1987 Weine FG. 1969 Hess W. 1925
7
of Time That ML Canal Is Located
Mesiolingual canal location, in vivo
10-39
Weller NR, Hartwell GR. 1983 Hartwell G, Bellizzi
R. 1982 Pomerantz H, Fishelberg G. 1974 Seidberg
BH. 1973
8
of Time That ML Canal Is Located
Different canal configurations
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Own Control
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12
Purpose
  • This presentation will demonstrate the enhanced
    ability of locating the mesial lingual canal in a
    maxillary molar using a surgical microscope.

13
Technique
  • Access is triangular
  • A 557 or straight fissure bur is used to make the
    initial outline form.
  • Begin the access near the palatal canal.

3 Major Canal Orifices Exposed
14
Technique
  • After the 3 main canals are located, remove the
    mesial ledge by using a 700L or a tapered fissure
    bur to uncover the mesial lingual canal orifice.

ML Canal Located Under a Shelf on the Mesial Wall
15
Technique
  • The MB orifice will be the guide to locate the
    ML.
  • This MB orifice must be clearly exposed.
  • Prepare a groove at that depth toward the lingual
    and slightly mesial into and through the shelf.

16
Sectioned and Stained 1st Molar
17
Technique
  • A groove will be made by extending lingual and
    slightly mesial towards the mesial lingual canal
    orifice.

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25
Technique
  • This groove may or may not open into a ML canal,
    depending upon whether it is present.
  • If a ML canal is not present, the MB canal will
    usually have a teardrop shape.

26
Technique
  • If a significant ML canal is present, it can be
    located with a small file.
  • Try using glycerin as a lubricant.
  • If the ML canal is not negotiable, it is too
    small and cannot be treated.

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32
Conclusions
  • The location of the Mesial Lingual canal in the
    Mesial Buccal root facilitates treatment of
    maxillary molars.
  • This presentation has demonstrated a simplied
    approach for location of the ML canal, which
    helps conserve tooth structure.

33
Conclusions
  • The most important consideration is that you look
    for the ML and/or other additional canals in
    every clinical case!!!
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