Locating Middle Mesial Canals
Avoid Missing a Canal in Hiding
The mandibular molar is traditionally described as a tooth with two canals in the mesial root. However, studies have shown that their anatomy can vary significantly, and a third canal is found in 15-25% of all cases. When working without magnification, it is likely that the middle mesial canal will be missed. However, the application of magnification and ultrasonics to trough between the mesiobuccal and mesiolingual canals with a diamond coated insert (E2D or E6D) can increase the probability of finding the middle mesial canal by up to 50%.
The orifice for the middle medial is usually located along the imaginary line connecting the mesiobuccal and the mesiolingual canals.
Step-by-Step Calcified Canal Location
1 – Using a diamond coated ultrasonic insert (E2D or E6D), create a groove connecting the mesiobuccal and the mesiolingual canals. This will remove secondary dentin, lighter in color.
2 – The dentin covering the pulp chamber floor and its mesial wall must be completely removed.
3 – Using a square section file, negotiate the middle mesial canal penetration, taking advantage of the sturdiness of these instruments.
1. Create a groove connecting the mesiobuccal and mesiolingual canals.
2. Locate the middle mesial canal orifice along the groove.
3. Use an appropriate file to negotiate and prepare the canal.
Achieved access to the Pulp Chamber.
Middle Mesial Canal located using ultrasonic.
Middle Mesial Canal final result.
Use the tip gently, as if you were using a 0.5mm mechanical pencil. The cutting does not come from the pressure applied, but from the vibration. Avoid working for more than 30 seconds without water flow – it can damage the hand piece due to overheating.
“I have been impressed with the responsiveness and quality of the Helse ultrasonic tips. They are my go to tips for custom bent apical surgery tips. I routinely use them for non-surgical endodontic therapy and have been impressed with their durability and quality. .”
Dr. Keith Kanter, DDS
Journal Articles & Research
Starter Packs to get you going.
We’ve assembled three separate starter packs packaged with a procedure field guide to get you started supercharging ultrasonics in your practice.
Endo Starter Pack
The Endo Starter Pack includes 6 Ultrasonics Tips to get you started with Pulp Chamber, Middle Third and Activation procedures.
Endo Master Pack
The Endo Master Pack includes 12 Ultrasonics Tips for Pulp Chamber, Middle Third, Activation, Post Removal and Retreatment procedures.
Endo Guru Pack
The Endo Guru Pack includes 18 Ultrasonics Tips for maximum flexibility with Pulp Chamber, Middle Third, Activation,Post Removal, Apical Surgery and Retreatment procedures.
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