scholarly journals Independent and Confluent Middle Mesial Root Canals in Mandibular First Molars: A Report of Four Cases

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Mohanavelu Deepalakshmi ◽  
Chellasamy Savarimala Karumaran ◽  
Revathi Miglani ◽  
Rajamani Indira

Mandibular molars demonstrate considerable variations with respect to number of roots and root canals. The possibility of additional root canals should be considered even in teeth with a low frequency of abnormal root canal anatomy. This paper discusses the endodontic management of the rare anatomical complexity middle mesial canals in mandibular first molar and also serves to remind the clinicians that such anatomical variations should be taken into account during the endodontic treatment of the mandibular molars.

2014 ◽  
Vol 142 (9-10) ◽  
pp. 592-596 ◽  
Author(s):  
Igor Stojanac ◽  
Milica Premovic ◽  
Milan Drobac ◽  
Bojana Ramic ◽  
Ljubomir Petrovic

Introduction. Predictable endodontic treatment depends on the dentist?s knowledge about root canal morphology and its possible anatomic variations. The majority of mandibular canines have one root and root canal, but 15% may have two canals and a smaller number may have two distinct roots. The following clinical reports describe endodontic treatment of mandibular canines with two roots and two root canals. Outline of Cases. Four clinical case reports are presented to exemplify anatomical variation in the human mandibular canine. Detailed analysis of the preoperative radiographs and careful examination of the pulp chamber floor detected the presence of two root canal orifices in all canines. Working length was determined with an electronic apex locator and biomechanical preparation was carried out by using engine driven BioRaCe Ni-Ti rotary instruments in a crown-down manner, followed by copious irrigation with 1% sodium hypochlorite. Definitive obturation was performed using cold lateral condensation with gutta-percha cones and Top Seal paste. The treatment outcome was evaluated using postoperative radiographs. Conclusion. Endodontists should be aware of anatomical variations of the treated teeth, and should never presume that canal systems are simple.


RSBO ◽  
2020 ◽  
Vol 17 (1) ◽  
pp. 12-20
Author(s):  
Flares Baratto-Filho ◽  
Nathaly Dias Morais ◽  
Kauhanna Vianna de Oliveira ◽  
Flávia Sens Fagundes Tomazinho ◽  
Carla Castiglia Gonzaga ◽  
...  

The aim of this study was to analyze the root canal anatomy variations of permanent mandibular molars using three different cone-beam computed tomography (CBCT) protocols. Material and methods: Thirty-five freshly extracted first and second mandibular molars were collected and subjected to three CBCT protocols: i-CAT Classic (ICC); i-CAT Next Generation (ICN), and PreXion 3D (PXD). Images were evaluated by two previously calibrated and experienced endodontists. The morphological root canal configurations were classified according to Vertucci. Data were analyzed for frequency, and the binomial and Kappa tests were then performed (α = 0.05). Results: ICC and ICN were able to diagnose a higher percentage of anatomical variations in the mesial roots. In this same root, Vertucci’s type V was the most prevalent, and in distal was the type I. In comparisons of CBCT techniques for agreement, significant differences in the mesial root canals were found in the following: ICC versus (vs) ICN; ICC vs PXD; and ICN vs PXD (p <0.001). However, there were no statistical differences in the distal root canals (p >0.05). The level of agreement in mesial roots was poor or absent, while in distal was moderate.


2017 ◽  
Vol 18 (7) ◽  
pp. 591-595
Author(s):  
Kishore Kumar Majety ◽  
Basanta Kumar Choudhury ◽  
Anika Bansal ◽  
Achla Sethi ◽  
Jaina Panjabi

ABSTRACT Introduction A thorough knowledge of the anatomic morphology of the root canal system is necessary for the long-term success of the root canal therapy. The occurrence of C-shaped root canal configuration is one such variation. Achievement of favorable prognosis after commencing root canal therapy in such teeth is one of the challenges imposed on the endodontist. Hence, we evaluated the healing occurring after endodontic therapy in patients with C-shaped root canals in mandibular molars. Materials and methods The present study was conducted in the Department of Conservative Dentistry of the institution and included assessment of all the patients who underwent root canal treatment of the mandibular first and second molars. Endodontic therapy was performed in all the cases by experienced endodontist. Final postoperative radiographs were taken. Recording of the data of the personal and clinical details of a total of 250 patients was done. All the clinical and radiographic details of the patients, such as tooth location in the jaw, presence or absence of C-shaped canals, status of the pulp tissue, presence or absence of the fractures, and other details of the patients were recorded. Radiographic and clinical examination of the tooth of the patients was done during the baseline visit and further during the follow-up visits. The presence of C-shaped root canals was confirmed using the radiographs. Periapical index (PI) scoring system was used. Categories defined for enlisting the healing after the root canal treatment with the assessment of the PI score. All the results were analyzed by Statistical Package for the Social Sciences software. Results Vital pulp tissue was encountered in majority of the cases. C-shaped root canal configuration was observed in 40% of the cases included in the present study. After completion of the endodontic therapy, complete crown placement was done in only 22% of the cases. In cases of vital teeth with C-shaped root canals configuration, most of the teeth showed complete healing. Significant results were obtained while comparing the complete coverage crown parameter in relation to the healing process in teeth with C-shaped root canals. Conclusion In the present study, no significant effect of the C-shaped root canal configuration was found on the healing rate of the endodontic therapy in mandibular molars. Clinical significance Meticulous endodontic therapy with special techniques should be done while preparing teeth with C-shaped root canals. How to cite this article Bansal A, Parihar AS, Sethi A, Majety KK, Panjabi J, Choudhary BK. Retrospective Assessment of Healing Outcome of Endodontic Treatment for Mandibular Molars with C-shaped Root Canal. J Contemp Dent Pract 2017;18(7):591-595.


2020 ◽  
Vol 18 (1) ◽  
pp. 27-30
Author(s):  
S. N. Razumova ◽  
A. S. Brago ◽  
Haydar Barakat ◽  
L. M. Khaskhanova ◽  
R. M. Bragunova

The success of endodontic treatment depends on many factors. The most important of them are the knowledge and manual skills of the dentist.Materials and methods. We analyzed the condition of teeth after endodontic treatment in 300 patients aged 20 to 70 years. Were studied 300 images of CBCT, the number of treated teeth and the number of cases of unsuccessful endodontic treatment was analyzed.Results. According to CBCT data, high-quality obturation of the root canal system was observed in 1335 (75%) endodontically treated teeth. The reasons for successful endodontic treatment are under-sealing of the root canal (16%), removal of material beyond the apex (5.6%), and missed root canals (3.4%).Conclusion. Clinical dental patient examination revealed that maxillary and mandibular molars most often undergo endodontic treatment.


2013 ◽  
Vol 1 (3) ◽  
pp. 246
Author(s):  
Keren Cristina Fagundes Jordão Basso ◽  
Milton Carlos Kuga ◽  
Katia Cristina Keine ◽  
Marina Oliveira Gonçalves Galoza ◽  
Marcus Vinicius Reis Só

PURPOSE: The purpose of this study was to evaluate the increase of the cervical area and dentin thickness in mesial and distal walls of the mesial canals from mandibular molars after the use of LA Axxess (LA), CP Drill (CP) and Gates-Glidden (GG) rotary instruments. MATERIAL AND METHODS: Sixty root canals from thirty mandibular first  molar were sectioned 3 mm below the cement-enamel junction, divided in 3 groups (n = 20 root canals, each) according to rotary instrument used, and the cervical images were captured before and after pre-enlargement instrumentation. The increase of the instrumented cervical area (mm2) and the dentin removal thickness (mm), at mesial and distal walls were calculated using Image tools software, by comparison of images. Data were analyzed by ANOVA and Tukey tests (p=0.05). RESULTS: All rotary instruments promoted thickness reduction in dentin walls. In mesial wall, all rotary instruments promoted similar thickness reduction of dentinal wall and did not differ from each other (p>0.05). In distal wall, LA Axxess instrument promoted higher dentin thickness reduction than other groups (p<0.05). The three rotary instruments promoted different increase at the instrumented cervical area (p<0.05), LA promoted the highest increase area and GG and CP presented similar results. CONCLUSION: LA 20/0.06 promoted the highest thickness reduction in distal wall and increase of cervical area of root canal. On the other hand, CP was the safest instrument, with lower dentin removal of distal wall and similar increased area to GG.


2015 ◽  
Vol 03 (02) ◽  
pp. 118-123
Author(s):  
Devendra Chaudhary ◽  
Niti Shah ◽  
Abhishek Bansal ◽  
Navneet Kukreja ◽  
Hitesh Nagarth

AbstractAberrations in the root canal anatomy are a commonly occurring phenomenon. A thorough knowledge of the basic root canal anatomy and its variations is necessary for successful completion of the endodontic treatment. The maxillary molars has fascinated researchers and clinicians for a variety of reasons. Endodontically, these are the most misunderstood teeth, and presents a variety of considerations for the treating practitioner. This case report presents the endodontic management of a maxillary first molar with five roots and five canals and another case of maxillary third molar with four canals. The clinical detection of the five canals was made using loupes and confirmed using computed tomography (CT) scanning. This report serves to remind clinicians that such anatomical variations should be taken into account during endodontic treatment of the maxillary molars.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Amit Kumar Garg ◽  
Rajendra Kumar Tewari ◽  
Neha Agrawal

Undetected extra roots or root canals are a major reason for failure of endodontic treatment. Failure to recognize an extra distolingual (DL) root in mandibular first molar may lead to incomplete debridement of the root canal system and eventually treatment failure. Therefore, it is crucial that atypical anatomy is identified before and during dental treatment. Spiral computed tomography (SCT) images can show 3D images, and therefore much detail can be used when traditional methods prevent adequate endodontic treatment. The overall incidence of DL roots on the mandibular first molars was 6.40% for all patients and 5.00% for all teeth, respectively. The occurrence of DL roots on the right side and on the left side showed a statistically significant difference. The bilateral incidence of symmetrical distribution of DL roots was 56.25%. The DL root canal orifice was separated from DB canal orifice by2.79±0.34 mm, from the MB canal orifice by4.23±0.81 mm, and from the ML canal orifice by3.29±0.52 mm. The high prevalence of the DL root in permanent mandibular first molars among the Indian population by using SCT and estimations of the interorifice distance of such teeth might be useful for successful endodontic treatments.


2015 ◽  
Vol 2015 ◽  
pp. 1-5
Author(s):  
Claudio Maniglia-Ferreira ◽  
Fabio de Almeida Gomes ◽  
Bruno Carvalho Sousa

Success in root canal treatment is achieved after thorough cleaning, shaping, and obturation of the root canal system. This clinical case describes conventional root canal treatment of an unusual mandibular first molar with six root canals. The prognosis for endodontic treatment in teeth with abnormal morphology is unfavorable if the clinician fails to recognize extra root canals.


2021 ◽  
Vol 33 (3) ◽  
pp. 262
Author(s):  
Diatri Nariratih ◽  
Hendra Dian Adhita Dharsono

ABSTRAKPendahuluan: Penatalaksanaan kasus penyakit pulpa yang disertai dengan lesi periapikal dapat dilakukan dengan perawatan saluran akar tanpa intervensi bedah. Preparasi biomekanis pada perawatan endodontik non-bedah dapat mengeliminasi bakteri dari saluran akar dan mencegah terjadinya infeksi berulang setelah dilakukannya obturasi. Kompleksitas anatomi menyebabkan keterbatasan preparasi biomekanis saluran akar, sehingga perawatan dapat mengalami kegagalan. Variasi anatomi saluran akar pada gigi molar pertama rahang atas umumnya terdapat pada bagian palatal akar mesiobukal yang disebut sebagai saluran akar mesiobukal kedua dengan insidensi 94%. Saluran akar mesiobukal kedua berukuran lebih sempit dan dangkal dibandingkan saluran akar mesiobukal pertama, sehingga dibutuhkan beberapa metode untuk menentukan lokasi orifis tersebut. Tujuan laporan kasus ini adalah membahas mengenai penatalaksanaan non-bedah gigi pasca perawatan endodontik parsial yang disertai dengan lesi periapikal. Laporan kasus: Pasien perempuan berusia 28 tahun datang dengan keluhan gigi belakang kiri atas sakit berdenyut sejak 1 bulan, gigi tersebut pernah dirawat saluran akarnya beberapa tahun sebelumnya. Pemeriksaan klinis menunjukkan terdapat tambalan permanen pada gigi 26. Pemeriksaan radiografis menunjukkan adanya gambaran radiopak pada email mesio-oklusal hingga mencapai dasar kamar pulpa, pelebaran ligamen periodontal, terputusnya lamina dura, serta lesi periapikal pada akar mesial dan palatal. Preparasi akses dilakukan pada gigi 26, dilanjutkan dengan penentuan lokasi orifis mesiobukal kedua. Empat saluran akar dipreparasi menggunakan instrumen rotary nickel titanium dengan teknik crown down dan dilakukan obturasi teknik kondensasi lateral. Restorasi definitif berupa mahkota penuh porselen. Simpulan: Lesi periapikal sembuh setelah dilakukan preparasi pada saluran akar mesiobukal kedua sehingga pengetahuan mengenai anatomi dan variasi internal saluran akar gigi sangat penting dalam keberhasilan perawatan endodontik non-bedah.Kata kunci: Perawatan endodontik non-bedah; previously initiated therapy; lesi periapical; mesiobukal kedua  ABSTRACTIntroduction: The management of pulp disease cases accompanied by periapical lesions can be done by root canal treatment without surgical intervention. Biomechanical preparations for non-surgical endodontic treatment can eliminate bacteria from the root canal and prevent re-infection after obturation. However, the complexity of the anatomy limits the biomechanical preparation of the root canal so that treatment can fail. Anatomical variations of the root canal in the maxillary first molars are generally found in the palatal part of the mesiobuccal root, which is the second mesiobuccal root canal with an incidence of 94%. The second mesiobuccal root canal is narrower and shallower than the first mesiobuccal root canal, so several methods are needed to determine the location of the orifice. The purpose of this case report was to discuss the non-surgical management of teeth after partial endodontic treatment accompanied by periapical lesions. Case report: A 28-year-old female patient complained of throbbing pain in the left upper back tooth for one month. The tooth had had its root canal treated several years before. Clinical examination revealed permanent fillings on tooth 26. Radiographic examination showed the radiopaque appearance of mesio-occlusal enamel to the floor of the pulp chamber, widening of the periodontal ligament, rupture of the lamina dura, and periapical lesions of the mesial and palatal roots. Access preparation was performed on tooth 26, followed by the determination of the location of the second mesiobuccal orifice. Four root canals were prepared using a rotary nickel titanium instrument with a crown down technique and obturation with lateral condensation technique. The definitive restoration is a full porcelain crown. Conclusions: Periapical lesions healed after preparation of the second mesiobuccal root canal. This result proves that knowledge of the anatomy and internal variations of the root canal is fundamental in the success of non-surgical endodontic treatment.Keywords: Non-surgical endodontic treatment; previously initiated therapy; periapical lesions; second mesiobuccal canal


2013 ◽  
Vol 14 (5) ◽  
pp. 980-986 ◽  
Author(s):  
Hamid Jafarzadeh ◽  
Zahed Mohammadi ◽  
Sousan Shalavi

ABSTRACT The main goal of endodontic treatment is healing of the periapical tissues which are gained by elimination of bacteria and their byproducts from the canal and prevention from reinfection. Understanding of root canal anatomy is an essential part in endodontic treatment. Anatomic forms and variations in special teeth should be well known, one of them is extra roots/ canals. Although possible aberrations of canal anatomy should be considered for all teeth, some teeth should be highlighted. This review addresses the prevalence, diagnosis (clinical and radiographic), and endodontic management of teeth with extra roots/canals. How to cite this article Mohammadi Z, Shalavi S, Jafarzadeh H. Extra Roots and Root Canals in Premolar and Molar Teeth: Review of an Endodontic Challenge J Contemp Dent Pract 2013;14(5):980-986.


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