The evolution of endodontics
For years, endodontics has evolved in a way that makes each day that passes, the outcome is becoming increasingly more positive and more favorable prognosis. The numerous techniques, with improved technology and increasingly moving towards the help of endodontic treatment, led to studies that converge in the reasons for endodontic failures.
The use of electronic devices such as apex locator, which brings you greater security in getting the CRD, the NiTi rotary files that help the biomechanical preparation of canals with sharp bends and ultrasound machines that help in the removal of fractured instruments, location channel and the removal of intracanal retainers. However, this does not become an absolute truth, because with the advancement of studies canal treatment was transformed into the treatment of root canals.
This happens because, in a contest X technology channel system, failures are still present in many cases. Several factors are taken into account, however there is one that I consider of great importance. The anatomical variation of the root canal system.
One of the most important anatomical variations and may lead to failure of endodontic treatment is the presence of the fourth canal in maxillary first molar. Most of the first molar mesiobuccal canal presents the palatine (the fourth channel), and this, when untreated, can be the cause of treatment failure.
According to Ruy Hizatugo, upper molars usually have two root canals in the mesio buccal - MV and MP channel. Histologically, the polls have shown MP channels in approximately 100% of cases. However, clinically, the MP channel is identified and treated in about 80% of cases without using surgical microscope and about 90% of cases with the aid of a microscope and ultrasonic tips.
So why has not failed in first molars that was not handled the mesio palatine canal? This happens because only 14% of cases: two independent channels in the mesiobuccal root.
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