ENDODONTIC TREATMENT OF A SECOND MAXILLARY MOLAR WITH FIVE ROOT CANALS – A Case Report (original) (raw)
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The Journal of Contemporary Dental Practice, 2019
Aim: The aim of this article was to promote a methodology in the endodontic management of complex premolars with multiple root canals Background: The success of endodontic treatment depends on a meticulous clinical and radiographic analysis, the creation of a suitable access cavity and chemical and mechanical preparation, followed by three-dimensional filling of the entire root canal system. Consequently, it is essential to look for the presence of additional root canals to prevent endodontic treatment failure Case description: Two cases are presented. The first case concerned a 50-year-old male patient of North African origin who consulted in the context of a global prosthetic restoration including endodontic treatment of the maxillary left first premolar (tooth no. 24). The second case concerned a 29-year-old male patient of North African origin who was referred to us by his primary care practitioner in an urgent context of pain and infection present for two weeks (tooth no. 44). In both cases, it was the in-depth radiographic analysis, combined with manual exploration under the surgical microscope, that led to the relatively rare identification of a third root canal. Shaping, disinfection and three-dimensional filling of the entire root canal system were then performed in accordance with widely validated protocols. Conclusion: The maxillary and mandibular premolars, due to their highly variable root canal system configuration and a number of root canals and roots, appear to be teeth for which treatment is potentially complex. The acuteness of digital-tactile sense and the advent of 3D imaging and optical aids optimize the treatment of all the root canals of a tooth Clinical significance: These case reports demonstrate the importance of clinical and radiographic inspections to guide practitioners in the search for additional root canals in premolars and promote a methodological approach.
Root canal treatment in a maxillary first molar with seven root canals
IP Indian Journal of Conservation and Endodontics, 2022
Aberrations in root canal anatomy can often pose challenges during an endodontic treatment. Failure to obturate all the root canals holistically can lead to sure endodontic failure. Thorough knowledge of such root canals together with technicality can aid us surpass the hurdles posed during a root canal treatment. This case report illustrates a root canal therapy performed in a pulpally involved maxillary first molar with seven root canals. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
International Journal of Case Reports and Images, 2012
Introduction: One of the most important steps in successful root canal treatment process is to understand the morphology of the root canal. Therefore, the clinicians should consider and release the anatomic variations in diagnosis and treatment of the mandibular and maxillary molars. Case Series: The aim of this case series is to present the successful root canal treatments completed in lower right first molar and in upper left first molar. In the first case; in right lower first molar five root canals were found, one root canal was in the mesibuccal root, one root canal was in the mesiolingual root and three root canals were in the distal root. This root canal treatment was completed in one session. In the second case, five root canals were found, two of them were in the mesibuccal root, in upper left first molar, two of them were in the distobuccal root and the fifth was in the palatinal root. The root canal treatment process was completed in three sessions. The clinical follow up performed after two years revealed that no symptoms were observed in both cases and the teeth were radiographically healthy. Conclusion: Successful endodontic treatment starts with proper clinical and radiographic examinations. It is important for clinicians to be aware of all possible anatomic variations for a good endodontic practice.
International Journal of Recent Scientific Research
Aim: anatomical variation in maxillary first premolar. Summary: two canals, it may rarely have three and this third canal can easily be missed. Thus meticulous knowledge of tooth morphology along with careful interpretation of angled radiographs, p access cavity preparation and a detailed exploration root canal is needed to ensure a proper endodontic treatment. This article reports a rare finding of three canals in a maxillary first premolar with non well defined root outline radiographically d INTRODUCTION Successful endodontic treatment requires a thorough knowledge of tooth anatomy and root canal morphology, so as to achieve a desired treatment outcome. present with a wide range of anatomical variations in the number, shape of root s and root canals (Vertucci 2005, Ahmed and Abott 2012, Ahmed and hashem 2016). important reason for failure of endodontic treatment is a missed root canal ¹′². The anatomy of maxillary 1 st premolar is such that it has two roots, two cusps i.e. buccal and palatal and most commonly two canals. Variations in the anatomy consists of fused roots with separate canals. fused roots with fused canals, fused canals with separate roots or separate roots with separate canals ′¹ ′¹¹. The prevalence of two canals is considered normal however and incidence of three canals accounts for 9.2 %. (Mariusz et al). The incidence of one root varies 29.9%, two roots 50.6 to 72% and three roots 0 to 6% ¹² This article describes a case report of maxillary 1 with three canals which is a rare clinical occurrence.
Non-surgical management of maxillary first molars with five root canals
Giornale Italiano di Endodonzia, 2021
Aim: This case series reports the nonsurgical management of five maxillary first molars with five root canals in different ethnic groups and geographic locations. Summary: Diagnosis and management of complex root canal anatomy, especially of the maxillary first molar, can be frustrating and challenging and also may increase the risk of failure if not managed with appropriate tools. In this case series the primary endodontic treatment of four, and a nonsurgical retreatment of one maxillary first molar with five root canals treated by three different endodontists from India, Spain, and Portugal has been described. None of the cases presented in the paper were performed without magnification and troughing of the pulp chamber floor using ultrasonic tips. Although CBCT wasn't used in all cases, its prudent use respecting the ALARA principle is highlighted in the paper. This paper also highlights the importance of anatomical variations in different ethnic groups with the maxillary first molar. Key-learning points • Operator should consider the ethnicity of the patient and thoroughly study pre-operative radiographs to carry out successful endodontic treatment. • Use of magnification and ultrasonic tips are fundamental especially in treating unusual canal anatomies. • The prudent use of CBCT should be performed respecting the ALARA principle in all given situations.
Endodontic management of maxillary permanent first molar with 6 root canals: 3 case reports
Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2010
This article discusses the successful endodontic management of 3 permanent maxillary first molars presenting with the anatomical variation of 3 roots and 6 root canals. A literature review pertaining to the variable root canal morphology of the permanent maxillary first molar is also presented. Modifications in the root canal access preparation and methods for examination of the pulpal floor with the aid of magnification for identification of additional canals are emphasized. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e79-e83)
External and Internal Root Canal Anatomy of the First and Second Permanent Maxillary Molars
A successful endodontic treatment depends on a comprehensive knowledge of the morphology of canal and its variations, an appropriate access cavity, cleaning and shaping, and adequate root canal filling. Lack of knowledge in this regard and missing a root canal are among the most common causes of failure of root canal treatments. Most previous studies on maxillary molars have reported that they usually have three roots and four canals since an extra canal is often found in the mesiobuccal root. Other anatomical variations, such as an extra C-shaped canal, have also been reported in distobuccal and palatal roots. Thus, because of having a more complex anatomy compared to other teeth, maxillary molars have the highest rate of endodontic failure. Several studies have assessed the morphology of root canal anatomy in different populations using different techniques such as sectioning, root canal clearing, association of a dental operating microscope and ultrasonic tips, periapical radiography, and computed tomography scanning. Recently, CBCT was suggested to three-dimensionally explore the root canal details before an endodontic treatment. The purpose of this chapter was to highlight the importance of having a thorough knowledge about the root canal morphology of the permanent first and second maxillary molar.
BMJ case reports, 2014
Root canal anatomy variations present a constant challenge in successful diagnosis and endodontic treatment, especially the multirooted teeth. Maxillary first molar is the most commonly treated tooth yet with frequent failures because of undetected canals, especially the mesiobuccal second canal (MB2) with more frequency and distobuccal second canal (DB2) with quite a less frequency. Also, there are limited chances to find MB2 in maxillary second molars. We present two such cases, each of maxillary first and second molar with extra distobuccal and mesiobuccal canals, respectively.
Root Canal Treament of Maxillary Molar With Second Mesiobuccal Canal – A Case Report
Advances in Health Scienced Research, 2019
An insight into the complexity of internal dental morphology is an important point for the planning and performing of root canal treatment. The undetected anatomical variations existing in the root canal system may contribute to the failure of root canal therapy. An additional root canal on the mesiobuccal root is one of the morphological variations of the maxillary first molar. A 25 year old male patient was reported to the Dental Hospital of Universitas Gadjah Mada with complaints of a big cavity in upper left first molar teeth. The tooth was not endodontically treated and there was no pain detected during the examination. Clinical examination revealed a pulp depth of distopalatoocclusal carious lesion with intrinsic discolouration. The second mesiobuccal root canal was detected during exploration. Preoperative radiographs showed pulp exposure and periradicular radiolucency. Diagnosis of tooth 26 was profound caries with necrotic pulp, asymptomatic apical periodontitis and intrinsic discolouration. Root canal treatment was carried out followed by prefabricated fibre post and porcelain fused to metal crown. Exploring the possibility of root canal variation would enhance the success of root canal treatment. The accurate instrumentation would help in the recognition and treatment of the second mesiobuccal canal.