Frequency and Pattern of 4th canal in permanent maxillary 1st molar Endodontic Department of Tertiary Care Hospital Khyber College of Dentistry Peshawar

Abstract

Background: The permanent maxillary first molar possesses a complex root canal system with frequent anatomical variations, particularly in the mesiobuccal root. The presence of an additional canal, commonly known as the fourth canal or MB2 canal, is clinically significant because failure to detect and treat it may lead to endodontic treatment failure. Objective: To determine the frequency and pattern of the fourth canal in permanent maxillary first molars in patients presenting to the Endodontic Department of Khyber College of Dentistry. Materials and Methods: A descriptive cross-sectional study was conducted in the Endodontic Department of Khyber College of Dentistry, Peshawar. Secondary data of 138 patients aged 15–60 years were collected from departmental records of patients treated during 2018. Patients having permanent maxillary first molars without systemic disease were included, while necrosed teeth were excluded. Radiographic records and patient files were carefully evaluated to identify the number and pattern of root canals. Data were entered and analyzed using SPSS, and descriptive statistics were applied to calculate frequencies and percentages. Results: Among the 138 permanent maxillary first molars examined, 116 teeth (84.1%) exhibited three canals, while 22 teeth (15.9%) demonstrated four canals. Of the teeth with four canals, the majority of additional canals were located in the mesiobuccal root in 20 cases (90.9%), whereas only 2 cases (9.1%) were found in the distobuccal root. Gender-wise analysis revealed slightly higher frequency of four canals among females compared to males. The occurrence of four canals was also slightly greater in left maxillary first molars than right maxillary first molars. Age-wise distribution showed that younger patients demonstrated a comparatively higher frequency of fourth canals. Conclusion: The present study demonstrated that the fourth canal occurs in a considerable number of permanent maxillary first molars, with the mesiobuccal root being the most common location. Careful clinical and radiographic examination, along with the use of advanced diagnostic aids, is essential for successful endodontic treatment and prevention of missed canals.

Keywords: Permanent maxillary first molar, Fourth canal, MB2 canal, Root canal morphology, Endodontics, Canal configuration.