Identification of second canals in the mesiobuccal root of maxillary first and second molars using magnifying loupes or an operating microscope.

Various authors have investigated the frequency of second canals (MB2) in the mesiobuccal roots of maxillary molars, predominantly first molars. Further, it has been reported that the percentage of MB2 canals that are treated during routine endodontic therapy is much lower than the number of second canals identified in vitro. It was the purpose of this study to investigate whether the use of an operating microscope may improve the diagnosis of MB2 canals in mesiobuccal roots of maxillary molars. The canal orifices of 100 maxillary first and second molars (50 of each) were initially inspected by Examiner 1 using individually-adapted x2 magnifying loupes. Subsequently, all teeth were examined by a second investigator using an operating microscope (OPM) with x8 magnification. Finally, the mesiobuccal roots of all teeth were separated. Then, the sections were analysed histologically and by SEM. The histological investigation revealed a total number of 63 MB2 canals, 39 in first, and 24 in second molars. Only 26 (41.3%) of those canals were identified using magnifying loupes, whereas 59 (93.7%) were found by means of an operating microscope.