Estudio de la configuración interna del primer molar permanente mediante CBCT y su implicación en endodoncia

The permanent first molar presents a complex internal anatomy, especially in the mesiobuccal root (MB), which complicates endodontic treatments due to anatomical variability and the difficulty in locating the second mesiobuccal canal (MB2). The failure to properly disinfect and fill all the canals can lead to persistent infections and clinical failure. Various analysis methods, such as conventional radiographs, clearing techniques, and cone-beam computed tomography (CBCT), have been used to study root morphology. CBCT has shown high effectiveness in identifying accessory canals and complex configurations. The configuration of the root canals has been classified using the Vertucci system, with types I, II, and IV being the most frequent in the MB root. Frequencies vary between populations due to genetic and ethnic factors. Studies have identified a higher prevalence of a fourth root in the first maxillary molar in certain populations, highlighting the importance of adapting endodontic techniques to the specific characteristics of each group. In the Ecuadorian population, a 41.7% frequency for the MB2 canal has been identified, confirming the anatomical complexity of this root. The success of endodontic treatment depends on the thorough localization and treatment of all root canals. Anatomical variability requires specialists to be trained to accurately interpret images and adapt treatment techniques to the specific anatomy of each patient.