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Predicting MB2 Canal Morphology From Contralateral Teeth: CBCT-Based Bilateral Symmetry Analysis.

Ronald Wigler1, Shir Rachmiel2, Zvi Metzger1

  • 1Department of Endodontology, The Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.

Australian Endodontic Journal : the Journal of the Australian Society of Endodontology Inc
|February 3, 2026
PubMed
Summary
This summary is machine-generated.

Cone-beam computed tomography (CBCT) reliably predicts the second mesio-buccal canal (MB2) in bilateral maxillary molars. This bilateral symmetry in CBCT scans aids in endodontic treatment planning for complex root canal anatomy.

Keywords:
CBCTMB2 canalcone‐beam computed tomographysecond mesio‐buccal canal

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Area of Science:

  • Endodontics
  • Dental Imaging
  • Anatomy

Background:

  • Maxillary molars frequently present complex root canal anatomy, specifically the second mesio-buccal canal (MB2), leading to endodontic treatment failure.
  • Cone-beam computed tomography (CBCT) is increasingly utilized for dental diagnostics, offering detailed 3D visualization of tooth structures.
  • The potential for using bilateral symmetry in CBCT scans to predict MB2 presence and configuration remains underexplored.

Purpose of the Study:

  • To evaluate the efficacy of CBCT in predicting the presence and configuration of the second mesio-buccal canal (MB2) in maxillary molars based on bilateral symmetry.
  • To compare the predictability of MB2 anatomy between homologous, adjacent, and contralateral maxillary molars using CBCT data.

Main Methods:

  • Ninety-nine CBCT scans of bilateral first and second maxillary molars were analyzed.
  • The prevalence of MB2 canals was determined for each tooth.
  • Vertucci classification was used to describe the canal configurations and compared across homologous, adjacent, and contralateral teeth.

Main Results:

  • MB2 canals were identified in 96.5% of first and 81.3% of second maxillary molars.
  • A strong correlation was observed between homologous first molars (91.9%) and homologous second molars (78.8%).
  • The agreement between adjacent or contralateral molars was significantly lower, approximately 60% (p < 0.05).

Conclusions:

  • CBCT imaging demonstrates high reliability in predicting the presence and configuration of the MB2 canal in bilateral maxillary molars.
  • The predictive value of CBCT for MB2 anatomy is strongest when comparing homologous (ipsilateral) teeth.
  • This bilateral symmetry correlation does not extend reliably to adjacent or contralateral maxillary molars, limiting its predictive use in those comparisons.