Association between second mesiobuccal missed canals and apical periodontitis in maxillary molars of a Chilean subpopulation

Background: To determine the frequency of missed second mesiobuccal canals (MB2) and apical periodontitis in maxillary molars of a Chilean subpopulation using cone beam computed tomography (CBCT). Material and Methods: Two previously calibrated operators evaluated CBCTs with a total of 588 upper molars, of which 179 endodontically treated molars were selected. Axial tomographic slices were used to study the frequency and association between the presence of apical periodontitis and untreated MB2 canals. Results: Of the 179 endodontically treated molars, 45.78% (84) presented MB2 missed canals. Of the upper molars that presented MB2 missed canals, 70% were associated with apical periodontitis, which was statistically significant (p < 0.0001). Sixty-two corresponded to first molars (74%) and 22 to second molars (26%). Of the first molars, 34 (54.8%) presented with apical periodontitis and MB2 missed canals (p < 0.0001), while 12 (54.4%) of the second molars presented this association (p = 0.081). Conclusions: MB2 missed canals are associated with a high degree of apical periodontitis and may be an important predictor of endodontic prognosis of upper molars.