Identification and Characterization of a Previously Undiscovered Anatomical Structure in Maxillary Second Molars: The Palato-Mesiobuccal Canal

Introduction: This report aims to communicate the discovery of a novel anatomy in a 3-rooted maxillary second molar, named as palato-mesiobuccal canal. Methods: The tooth selected for this report was found incidentally as a result of a study on extracted maxillary molars that was being conducted for an unrelated purpose and involved hundreds of teeth. This 3-rooted maxillary second molar was scanned using a micro-computed tomography device set at a pixel size of 13.68 mm. The images were reconstructed with previously tested parameters resulting in the acquisition of 1655 axial cross-sections. Three-dimensional (3D) models of the internal and external anatomies were generated in Standard Tessellation Language (STL) format and were texturized to simulate the pulp tissue. The inner structure of the tooth was analyzed through the axial cross sections and the 3D volume was qualitatively evaluated. Results: The analysis of the 3D models revealed that the maxillary second molar under examination has 3 independent roots and 4 root canals. Each root (mesiobuccal, distobuccal, and palatal) contains 1 canal, while the fourth canal follows a unique path, originating in the coronal third of the palatal canal and proceeding in a buccal direction ultimately exiting through an independent foramen at the apex of the mesiobuccal root, near the mesiobuccal canal. Conclusions: This brief communication reports the discovery of a novel anatomy in a 3-rooted maxillary second molar, named as palato-mesiobuccal canal, and provides important insights into the complexity of the root canal system in this group of teeth. (J Endod 2023;49:730-734.)