Conventional and Surgical Endodontic Retreatment of A Maxillary First Molar: Unusual Anatomy

Maxillary First Molars with 2 Distobuccal Canals: A Case Series

An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. Eight patients underwent nonsurgical root canal treatment of 3-rooted maxillary first molars in a specialty endodontic private practice. Four cases of Weine type II and 4 cases of Weine type III canal configurations in the distobuccal root of maxillary first molars were presented.This article highlighted an uncommon anatomic variation of 2 canals in the distobuccal root of the maxillary first molar.

Evaluation of the root and canal systems of maxillary molars in Taiwanese patients: A cone beam computed tomography study

Background

This study evaluated variations in root canal configuration in the maxillary permanent molars of Taiwanese patients by analyzing patients' cone beam computed tomography (CBCT) images. Comparisons were made among these configurations and those previously reported. This information may serve as a basis for improving the success rate of endodontic treatment.

Methods

The root canal systems of 114 Taiwanese patients with bilateral maxillary first or second molars were examined using CBCT images. The number of roots, canals per root, and additional mesiobuccal (MB) canals, as well as the canal configuration were enumerated and recorded.

Results

Of the 196 maxillary first molars examined, three (1.5%) had a single root, two (1.0%) had two roots, and 191 (97.5%) had three separate roots. Out of all first molar roots examined, 44% of mesiobuccal (MB) roots had a single canal and the remainder had a second MB (MB2) canal. Of the 212 maxillary second molars examined, 16 (7.1%) had a single root, 51 (24.2%) had two roots, 143 (67.8%) had three roots, and two (0.9%) had four separate roots. For the MB roots, 92.3% of three-rooted maxillary second molars had a single canal and the remainder had an MB2 canal. In all three-rooted maxillary first and second molars, each of the distal and palatal roots had one canal.

Conclusions

The root canal configurations of the MB roots of maxillary molars were more varied than those of the distobuccal and palatal roots, and the root canal configurations of maxillary second molars were more varied than those of the first molars. These findings demonstrate CBCT as a useful clinical tool for endodontic diagnosis and treatment planning.

A rare root canal configuration of bilateral maxillary first molar with 7 root canals diagnosed using cone-beam computed tomographic scanning: a case report

INTRODUCTION

The complexity of the root canal system of maxillary molars presents a constant challenge in the diagnosis and treatment of these teeth. This case report describes the importance of a surgical operating microscope and cone-beam computed tomographic (CBCT) imaging.

METHODS

Root canal treatment of a left maxillary first molar with 3 roots and 7 canals was successfully performed. Seven canals were identified with the help of a surgical operating microscope and CBCT imaging. CBCT images also confirmed the 3 roots and 7 canals in the right maxillary first molar.

RESULTS

CBCT images confirmed a type IV canal pattern in the distal and palatal root, whereas the mesial root had a type VIII canal pattern.

CONCLUSIONS

The use of a surgical operating microscope and CBCT imaging helps the clinician to diagnose unusual anatomy of a tooth and facilitate successful endodontic treatment.

Conventional and surgical endodontic treatment of a maxillary first molar with unusual anatomy--a case report

AIM

To describe conventional and surgical endodontic treatment of a maxillary left first molar with two canals on the distobuccal root and to discuss the treatment outcome.

SUMMARY

According to the literature, the presence of a second canal on the distobuccal root of a maxillary first molar is rare. This anatomical anomaly might lead to an unfavourable outcome if clinicians fail to identify and treat it properly. The following case report describes conventional and surgical endodontic treatment of a maxillary left first molar with two canals on the distobuccal root. Key learning points • Anatomical variations of the root canal system are a challenge for clinicians during root canal retreatment. • The principles and techniques of endodontic microsurgery are of utmost importance in clinical practice, and clinicians should be aware of them.

Use of CBCT to identify the morphology of maxillary permanent molar teeth in a Chinese subpopulation

AIM

To investigate variations in root canal configuration in the maxillary permanent molar teeth of a Chinese subpopulation using cone-beam computed tomography (CBCT).

METHODOLOGY

A total of 269 patients with healthy, untreated, well-developed maxillary molars were enrolled, including those suffering facial trauma, and those who required a pre-operative assessment for implants. Radiographic examination by CBCT was conducted as part of their routine examination, diagnosis and treatment planning. Overall, 299 maxillary first and 210 maxillary second molar teeth were examined in vivo by CBCT. The number of roots, the number of canals per root, the canal configuration and the presence of additional mesiobuccal canals were recorded. Vertucci's classification for root-canal configurations was utilized.

RESULTS

All maxillary first molars had three separate roots; however, 52% of mesiobuccal (MB) roots had two canals with the remainder having one. All distobuccal and palatal roots had Vertucci Type I canal configurations. When the MB2 canal was present, 14, 69 and 16% of MB roots had Type II, IV and V canal configurations, respectively. The root canal system of the maxillary first molar teeth could be categorized into two variants: one with three separate roots with one canal in each of the distobuccal and palatal roots and two canals in the MB root, and the other with three separate roots with one canal in each root. Of 210 maxillary second molars, 10% had one root, 8% two roots and 81% three roots. Of the MB roots, 22% had two canals with the remainder having one. When the MB2 canal was present, 18%, 58%, 10% and 3% of MB roots had type II, IV, V and VI canal configurations, respectively. The root canal system of the maxillary second molar could be categorized into eight variants.

CONCLUSIONS

Mesiobucccal roots of maxillary molar teeth had more variation in their canal system than the distobuccal or palatal roots. The root canal configuration of the maxillary second molars was more variable than that of the first molars. CBCT can enhance detection and mapping of the mesiobuccal root-canal system with the potential to improve the quality of root canal treatment.

Maxillary first molar with seven root canals diagnosed with cone-beam computed tomography scanning: a case report

INTRODUCTION

The purpose of this article was to emphasize the importance of having a thorough knowledge about the root canal anatomy.

METHODS

This case report presents the endodontic management of a maxillary first molar with three roots and seven canals. The clinical detection of the seven canals was made using a surgical operating microscope and confirmed using cone-beam computed tomography (CBCT) scanning.

RESULTS

CBCT axial images showed that both the palatal and distobuccal root have a Vertucci type II canal pattern, whereas the mesiobuccal root showed a Sert and Bayirli type XV canal configuration.

CONCLUSION

This report describes and discusses the variation in canal morphology of maxillary first molar and the use of latest adjuncts in successfully diagnosing and negotiating them.