Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Endodontic management of a maxillary first molar with three roots and seven root canals with the aid of cone-beam computed tomography

  • Nayak, Gurudutt (Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences) ;
  • Singh, Kamal Krishan (Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital) ;
  • Shekhar, Rhitu (Department of Conservative Dentistry and Endodontics, Kanti Devi Dental College and Hospital)
  • Received : 2015.02.27
  • Accepted : 2015.04.13
  • Published : 2015.08.31
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Abstract

Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies.

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References

  1. Slowey RR. Radiographic aids in the detection of extra root canals. Oral Surg Oral Med Oral Pathol 1974;37:762-772. https://doi.org/10.1016/0030-4220(74)90142-X
  2. Hartwell G, Bellizzi R. Clinical investigation of in vivo endodontically treated mandibular and maxillary molars. J Endod 1982;8:555-557. https://doi.org/10.1016/S0099-2399(82)80016-2
  3. Kulild JC, Peters DD. Incidence and configuration of canal systems in the mesiobuccal root of maxillary first and second molars. J Endod 1990;16:311-317. https://doi.org/10.1016/S0099-2399(06)81940-0
  4. Caliskan MK, Pehlivan Y, Sepetcioglu F, Turkun M, Tuncer SS. Root canal morphology of human permanent teeth in a Turkish population. J Endod 1995;21:200-204. https://doi.org/10.1016/S0099-2399(06)80566-2
  5. Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod 2004;30:391-398. https://doi.org/10.1097/00004770-200406000-00004
  6. Kumar R. Report of a rare case: a maxillary first molar with seven canals confirmed with cone-beam computed tomography. Iran Endod J 2014;9:153-157.
  7. Badole GP, Warhadpande MM, Shenoi PR, Lachure C, Badole SG. A rare root canal configuration of bilateral maxillary first molar with 7 root canals diagnosed using cone-beam computed tomographic scanning: a case report. J Endod 2014;40:296-301. https://doi.org/10.1016/j.joen.2013.09.004
  8. Kaushik M, Mehra N. Maxillary first molars with six canals diagnosed with the aid of cone beam computed tomography: a report of two cases. Case Rep Dent 2013;2013:406923.
  9. Kakkar P, Singh A. Maxillary first molar with three mesiobuccal canals confirmed with spiral computer tomography. J Clin Exp Dent 2012;4:e256-e259.
  10. Zhang P, Mao LS. Left maxillary first molar with three mesiobuccal canals: a case report. Beijing Da Xue Xue Bao 2011;43:919-920.
  11. Ayranci LB, Arslan H, Topcuoglu HS. J Conserv Dent 2011;14:436-437. https://doi.org/10.4103/0972-0707.87222
  12. Kottoor J, Velmurugan N, Surendran S. Endodontic management of a maxillary first molar with eight root canal systems evaluated using cone-beam computed tomography scanning: a case report. J Endod 2011;37:715-719. https://doi.org/10.1016/j.joen.2011.01.008
  13. Du Y, Soo I, Zhang CF. A case report of six canals in a maxillary first molar. Chin J Dent Res 2011;14:151-153.
  14. Ma L, Yu J, Sun JJ. Maxillary first molar with three mesiobuccal root canals: a case report. Hua Xi Kou Qiang Yi Xue Za Zhi 2011;29:102-103.
  15. Kottoor J, Velmurugan N, Sudha R, Hemamalathi S. Maxillary first molar with seven root canals diagnosed with cone-beam computed tomography scanning: a case report. J Endod 2010;36:915-921. https://doi.org/10.1016/j.joen.2009.12.015
  16. Garg AK, Tewari RK, Kumar A, Agrawal N. Endodontic treatment of a maxillary first molar having three mesiobuccal canals with the aid of spiral computed tomography: a case report. J Oral Sci 2010;52:495-499. https://doi.org/10.2334/josnusd.52.495
  17. Favieri A, Barros FG, Campos LC. Root canal therapy of a maxillary first molar with five root canals: case report. Braz Dent J 2006;17:75-78. https://doi.org/10.1590/S0103-64402006000100017
  18. Ferguson DB, Kjar KS, Hartwell GR. Three canals in the mesiobuccal root of a maxillary first molar: a case report. J Endod 2005;31:400-402. https://doi.org/10.1097/01.don.0000148147.01937.6d
  19. Beatty RG. A five-canal maxillary first molar. J Endod 1984;10:156-157. https://doi.org/10.1016/S0099-2399(84)80119-3
  20. Martinez-Berna A, Ruiz-Badanelli P. Maxillary first molars with six canals. J Endod 1983;9:375-381. https://doi.org/10.1016/S0099-2399(83)80188-5
  21. Karthikeyan K, Mahalaxmi S. New nomenclature for extra canals based on four reported cases of maxillary first molars with six canals. J Endod 2010;36:1073-1078. https://doi.org/10.1016/j.joen.2009.12.001
  22. Maggiore F, Jou YT, Kim S. A six-canal maxillary first molar: case report. Int Endod J 2002;35:486-491. https://doi.org/10.1046/j.1365-2591.2002.00533.x
  23. Wong M. Maxillary first molar with three palatal canals. J Endod 1991;17:298-299. https://doi.org/10.1016/S0099-2399(06)81871-6
  24. Baratto Filho F, Zaitter S, Haragushiku GA, de Campos EA, Abuabara A, Correr GM. Analysis of the internal anatomy of maxillary first molars by using different methods. J Endod 2009;35:337-342. https://doi.org/10.1016/j.joen.2008.11.022
  25. Martins JN. Endodontic treatment of a maxillary first molar with seven root canals confirmed with cone beam computer tomography - case report. J Clin Diagn Res 2014;8:ZD13-ZD15.
  26. Al-Qudah AA, Awawdeh LA. Root and canal morphology of mandibular first and second molar teeth in a Jordanian population. Int Endod J 2009;42:775-784. https://doi.org/10.1111/j.1365-2591.2009.01578.x
  27. Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod 2006;32:813-821. https://doi.org/10.1016/j.joen.2006.04.014
  28. Degerness RA, Bowles WR. Dimension, anatomy and morphology of the mesiobuccal root canal system in maxillary molars. J Endod 2010;36:985-989. https://doi.org/10.1016/j.joen.2010.02.017
  29. Lee JH, Kim KD, Lee JK, Park W, Jeong JS, Lee Y, Gu Y, Chang SW, Son WJ, Lee WC, Baek SH, Bae KS, Kum KY. Mesiobuccal root canal anatomy of Korean maxillary first and second molars by cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:785-791. https://doi.org/10.1016/j.tripleo.2010.11.026
  30. Kim Y, Lee SJ, Woo J. Morphology of maxillary first and second molars analyzed by cone-beam computed tomography in a Korean population: variations in the number of roots and canals and the incidence of fusion. J Endod 2012;38:1063-1068. https://doi.org/10.1016/j.joen.2012.04.025
  31. Verma P, Love RM. A Micro CT study of the mesiobuccal root canal morphology of the maxillary first molar tooth. Int Endod J 2011;44:210-217. https://doi.org/10.1111/j.1365-2591.2010.01800.x
  32. Kim Y, Chang SW, Lee JK, Chen IP, Kaufman B, Jiang J, Cha BY, Zhu Q, Safavi KE, Kum KY. A micro-computed tomography study of canal configuration of multiplecanalled mesiobuccal root of maxillary first molar. Clin Oral Investig 2013;17:1541-1546. https://doi.org/10.1007/s00784-012-0852-8

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  1. Endodontic Management of Maxillary First Molar with Seven Root Canals Diagnosed Using Cone-beam Computed Tomography: A Case Report vol.12, pp.1, 2015, https://doi.org/10.5005/jp-journals-10015-1789