03/02/2026
๐ ๐๐๐๐๐ฎ๐ ๐๐๐๐ฃ๐๐ค๐ฌ ๐๐๐ก๐๐จ ๐พ๐๐จ๐ ๐๐๐๐ง๐๐ฃ๐
Lower molar with 6 canals.
What does this video indicate regarding the canals?
It shows that there is a confluence of canals, but is it evidence that the canals merge at a single apex? As Mahmoud Akoula mentioned: "Canal confluence does not necessarily mean merging at the same apex; each canal may have a separate apical foramen. However, there can be confluence at different points along the canal with an Isthmus between them."
This is exactly what we see here: the ML and MM canals merge at the same apex, while the MB canal has a separate apex. Thus, we have two separate apical terminations in the mesial root. However, the three canals in the distal root converge at the same apex.
The key point is that extrusion of bioceramic sealer from canals within the same root is not always proof of their merging at a single apex. It could be due to an Isthmus or a 2-1-2 configuration according to Vertucciโs classification.
Radiographs are the most informative tool to assess this.
Of course, what helped us locate the MM canal and probe the Isthmus was persistent bleeding despite canal preparation, especially in the apical third.
Canals were prepared using blue 4% files.
