• Journal of Periodontal and Implant Science
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• v.39 no.3
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• pp.375-381
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• 2009

Purpose: Root resection can be a valuable procedure when the tooth in question has a high strategic value. The prognosis of root resection has been well documented in previous studies, but the results focused on the palatal root resection have not been discussed in depth. I represent here the short term effectiveness of palatal root resection of maxillary first molars. Methods: Palatal root resection was performed on maxillary first molars of three patients. All the palatal roots were floating state on the radiographic finding and showed full probing depth and purulent exudation at initial examination. Reduction of palatal cusp and occlusal table was performed concomitantly. Endodontic therapy was completed after root resection. Results: Compromised maxillary first molars were treated successfully by palatal root resection in 3 cases. The mobility of resected tooth was decreased a little bit. The probing pocket depth of remaining buccal roots was not increased compared to initial depth. All the patients satisfied with comfort and cost effective results and the fact they could save their natural teeth. Conclusions: Within the above results, palatal root resection is an effective procedure treating compromised maxillary first molar showing advanced palatal bone loss to root apex with or without pulp involvement when proper case selection is performed.

• Restorative Dentistry and Endodontics
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• v.41 no.4
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• pp.322-331
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• 2016

Variation in the root and canal morphology of the maxillary first molars is quite common. The most common configuration is 3 roots and 3 or 4 canals. Nonetheless, other possibilities still exist. The presence of an additional palatal root is rather uncommon and has been reported to have an incidence of 0.06 - 1.6% in varying populations studied. Whenever two palatal roots exist, one of them is the normal palatal root, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). This case report describes successful endodontic treatment of a maxillary first molar with radix mesiolingualis and radix distolingualis. Identification of this variation was done through clinical examination along with the aid of multiangled radiographs, and an accurate assessment of this morphology was made with the help of a cone-beam computed tomography imaging. In addition to the literature review, this article also discusses the epidemiology, classifications, morphometric features, guidelines for diagnosis, and endodontic management of a maxillary first molar with extra-palatal root.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.4
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• pp.421-426
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• 2011

Most of the intraoral infections origin in odontogenic infection. Odontogenic infection spreads out along the least resistant path. In maxilla, the thickness between periapical area and cortical bone is narrower on the buccal side than the palatal side. So infection usually spreads out along the buccal side rather than the palatal side. The failure of root canal treatment more frequently occurs on the buccal root compared to the palatal root. So the palatal abscess is rarer than the buccal abscess. It is difficult to differential diagnosis palatal abscess from salivary gland tumors, benign neural tumors and cysts on the palate. Therefore, when the palatal swelling is observed in children, you need to prevent the systemic spread of infection by early diagnosis of the odontogenic palatal abscess. In these cases, the patient who complained of the pain in deciduous teeth and the palatal swelling was diagnosed with odontogenic palatal abscess. The patient was treated with extraction and antibiotic medication. The palatal abscess was resolved, and we report after treatments.

• The korean journal of orthodontics
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• v.31 no.6 s.89
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• pp.549-558
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• 2001

This study was undertaken to demonstrate the forces in the maxillary alveolar bone generated by the activation of the maxillary posterior crossbite appliance In the treatment of posterior buccal crossbite caused by buccal ectopic eruption of the maxillary second molar. A photoelastic model was fabricated using a Photoelastic material (PL-3) to simulate alveolar bone and ivory-colored resin teeth. The model was observed throughout the anterior and posterior view in a circular polariscope and recorded photographically before and after activation of the maxillary posterior crossbite appliance. The following conclusions were reached from this investigation : 1. When the traction force was applied on the palatal surface of the second molar, stresses were concentrated at the buccal and palatal root apices and alveolar crest area. The axis of rotation of palatal root was at the root apex and that of the buccal root was at the root li4 area. In this result, palatal tipping and rotating force were generated. 2. When the traction force was applied on the buccal surface of the second molar, more stresses than loading on the palatal surface were observed in the palatal and buccal root apices. Furthermore, the heavier stresses creating an intrusive force and controlled tipping force were recorded below the buccal and palatal root apices below the palatal root surface. In addition, the axis of rotation of palatal root disappeared whereas the rotation axis of the buccal root moved to the root apex from the apical 1/4 area. 3. When the traction force was simultaneously applied on the maxillary right and left second molars, the stress intensity around the maxillary first molar root area was greater than the stress generated by the only buccal traction of the maxillary right or left second molar. As in above mentioned results, we should realize that force application on the palatal surface of second molars with the maxillary posterior crossbite appliance Produced rotation of the second molar and palatal traction, which nay cause occlusal Interference. That is to say, we have to escape the rotation and uncontrolled tipping creating occlusal interference when correcting buccal posterior crossbite. For this purpose, we recommend buccal traction rather than palatal traction force on the second molar.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.1
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• pp.87-92
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• 2016

The purpose of this clinical report was to show anatomical variations in permanent maxillary second molar using computed tomography (CT). This case report describes the application of CT to detect the unusual root anatomy of maxillary second molar with 2 separate palatal roots for successful endodontic treatment procedures. The use of cone beam computed tomography (CBCT) can overcome the limitation of the periapical standard radiography caused by the overlap of buccal and secondary palatal roots.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.11.1-11.5
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• 2015

Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.

• Journal of Periodontal and Implant Science
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• v.25 no.1
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• pp.146-152
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• 1995

A mucogingival grafting procedure has been developed to cover denuded root surfaces. The subepithelial connective tissue graft is composed of a free connective tissue graft and an overlying pedicle graft. The source of connective tissue graft were trap door approach and thining of a full thickness palatal flap. The purpose of this study was compare a two different connective tissue obtaining method. In this study, where palatal pocket was present, pocket elimination was performed, and the tissue normally discarded after thinning of the palatal flap was used as a grafting material. The results were as follows : 1. The mean difference between trap door approach and thinning procedure for root coverage were $2.1{\pm}O.lmm$, $2.2{\pm}O.2mm$. 2. The mean difference between trap door approach and thinning procedure for pocket depth change were $O.2{\pm}O.lmm$, $O.2{\pm}O.2mm$. 3. The mean difference between trap door approach and thinning procedure for attachment gain were $2.1{\pm}O.2mm$, $2.4{\pm}O.2mm$. 4. The esthetics in recipient site, both color match and tissue contour, were acceptable to the patient in all cases. 5. Therefore, thinning procedure were similar to trap door approach in root coverage effect.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.6.1-6.9
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• 2022

Objectives: This study investigated the internal morphology of mesiobuccal (MB) roots of maxillary molars with a second mesiobuccal (MB2) canal. Materials and Methods: Forty-seven maxillary first or second molars from Brazilians were scanned using micro-computed tomography. The following measurements were obtained from the MB roots: root thickness, root width, and dentin thickness of the buccal aspect of the first mesiobuccal (MB1) canal, between the MB1 and MB2 canals, and the palatal aspect of the MB2 and MB1 canals at 3 mm from the root apex and in the furcation region. For statistical analysis, the Student's t-test and analysis of variance with the post-hoc Tukey test were used (α = 0.05). Results: In maxillary molars with an MB2 canal, MB roots were significantly thicker (p = 0.0014) and narrower (p = 0.0016) than in maxillary molars without an MB2 canal. The dentin thickness of the palatal aspect of the MB1 canal was also significantly greater than that of MB roots without an MB2 canal at 3 mm from the root apex (p = 0.0007) and in the furcation region (p < 0.0001). In the furcation region of maxillary molars with an MB2 canal, the dentin thickness between the MB1 and MB2 canals was significantly smaller than that in the buccal and palatal aspects (p < 0.0001). Conclusions: The internal morphology of MB roots of maxillary molars with an MB2 canal revealed differences in dentin thickness, root diameter, and distance between the canals when compared with maxillary molars without an MB2 canal.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.4 no.1
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• pp.1-5
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• 1995

A mucogingival grafting procedure has been developed to cover denuded root surfaces. This procedures need to connective tissue, so many clinician open the trap door to palatal side of the patient. In this study, where palatal pocketing was present, pocket elimination was performed, and the tissue normally discarded after thinning of the palatal flap was used as a grafting material. The esthetics in recipient site, both color match and tissue contour were acceptable to the patient in this case.

• Restorative Dentistry and Endodontics
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• v.40 no.3
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• pp.241-248
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• 2015

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.