MB2 Canals and Global Microscope Magnification

Ah, the canals of Venice, and other places I've never been:

 
Yet I do spend quite a bit of time in those other canals, the very small ones, the ones inside of the roots of teeth that sometimes go awry and give patients pain. 

 

The root canal systems inside of human teeth are very complex.  It's like having a main street, but then lots of side streets and interconnecting avenues that all have to be cleaned up in detail.  And they all curve; no straight lines.  It's most definitely not one simple straight tube that we have to deal with when we are faced with cleaning this system of infected tissue.

Upper first molars are particularly difficult to cleanse.  The above graphic depicts one.  There are often four main canals in these teeth.  The palatal goes off towards- you guessed it- the palate, or roof of the mouth.  The disto-buccal is the one farther back (distal) and towards the cheek (bucca means cheek in Latin).  The  mesio-buccal 1 is the one towards the front and cheek. 

The problems tend to occur around the mesio-buccal 2, or MB2 for short.   This canal is usually very small and difficult to find even in the best of circumstances.  As we get older, or have many procedures done on a tooth over the years, the canals get smaller.  Often so much smaller that they cannot be found at all, which is not good, because if they cannot be found, they cannot be cleaned. 

See:

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2010/09/dental-pulp-calcification-spelunking-in-the-dentin.html

http://rickwilsondmd.typepad.com/rick_wilson_dmds_blog/2011/01/dental-pulp-calcification-and-changes-with-age.html

When using the Global Operating Microscope, I find that the whole game has changed.  Tiny MB2 canals that I struggled to find are now things that I trip over in broad daylight.  Here is an image to show you what I mean:

 

(These video captures show what we see through the eyepieces of the microscope, but they do not at all give the 3-D visceral feel that one gets by looking through the actual optics.) 

The other three canals that can be seen in this image have been enlarged and cleaned up already in the course of treatment.  The MB2 is now readily apparent, magnified, and lit up with the dental equivalent of Kleig lights.  This is a tremendous benefit to our patients, as we can now find (and clean) a much higher percentage of these canals than before we had this device.

 

Comments

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[Samuel Hershey]

Ohhh...that looks disturbingly painful. But thanks for sharing this vital piece of information about canals. Next time I have a root canal, I'll understand that its not an easy task to get into all these canals inside the tooth. The picture says a thousand words.