Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
권호 표지
DOI QR코드

DOI QR Code

Endodontic treatment of a C-shaped mandibular second premolar with four root canals and three apical foramina: a case report

  • Bertrand, Thikamphaa (Division of Endodontics, Columbia University College of Dental Medicine) ;
  • Kim, Sahng Gyoon (Division of Endodontics, Columbia University College of Dental Medicine)
  • Received : 2015.09.08
  • Accepted : 2015.12.04
  • Published : 2016.02.29
Download PDF
⟨ Previous Next ⟩

Abstract

This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT). C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure.

Keywords

References

  1. Pineda F, Kuttler Y. Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals. Oral Surg Oral Med Oral Pathol 1972;33:101-110. https://doi.org/10.1016/0030-4220(72)90214-9
  2. 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
  3. Awawdeh LA, Al-Qudah AA. Root form and canal morphology of mandibular premolars in a Jordanian population. Int Endod J 2008;41:240-248. https://doi.org/10.1111/j.1365-2591.2007.01348.x
  4. Zillich R, Dowson J. Root canal morphology of mandibular first and second premolars. Oral Surg Oral Med Oral Pathol 1973;36:738-744. https://doi.org/10.1016/0030-4220(73)90147-3
  5. Holtzman L. Root canal treatment of mandibular second premolar with four root canals: a case report. Int Endod J 1998;31:364-366. https://doi.org/10.1046/j.1365-2591.1998.00166.x
  6. Bram SM, Fleisher R. Endodontic therapy in a mandibular second bicuspid with four canals. J Endod 1991;17:513-515. https://doi.org/10.1016/S0099-2399(06)81801-7
  7. Rhodes JS. A case of unusual anatomy: a mandibular second premolar with four canals. Int Endod J 2001;34:645-648. https://doi.org/10.1046/j.1365-2591.2001.00441.x
  8. Macri E, Zmener O. Five canals in a mandibular second premolar. J Endod 2000;26:304-305. https://doi.org/10.1097/00004770-200005000-00016
  9. Sachdeva GS, Ballal S, Gopikrishna V, Kandaswamy D. Endodontic management of a mandibular second premolar with four roots and four root canals with the aid of spiral computed tomography: a case report. J Endod 2008;34:104-107. https://doi.org/10.1016/j.joen.2007.10.004
  10. Yu X, Guo B, Li KZ, Zhang R, Tian YY, Wang H, Hu T. Cone-beam computed tomography study of root and canal morphology of mandibular premolars in a western Chinese population. BMC Med Imaging 2012;12:18. https://doi.org/10.1186/1471-2342-12-18
  11. Rahimi S, Shahi S, Yavari HR, Manafi H, Eskandarzadeh N. Root canal configuration of mandibular first and second premolars in an Iranian population. J Dent Res Dent Clin Dent Prospects 2007;1:59-64.
  12. Jafarzadeh H, Wu YN. The C-shaped root canal configuration: a review. J Endod 2007;33:517-523. https://doi.org/10.1016/j.joen.2007.01.005
  13. Lu TY, Yang SF, Pai SF. Complicated root canal morphology of mandibular first premolar in a Chinese population using the cross section method. J Endod 2006;32:932-936. https://doi.org/10.1016/j.joen.2006.04.008
  14. Sidow SJ, West LA, Liewehr FR, Loushine RJ. Root canal morphology of human maxillary and mandibular third molars. J Endod 2000;26:675-678. https://doi.org/10.1097/00004770-200011000-00011
  15. 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
  16. Manning SA. Root canal anatomy of mandibular second molars. Part II. C-shaped canals. Int Endod J 1990;23:40-45. https://doi.org/10.1111/j.1365-2591.1990.tb00801.x
  17. Barnett F. Mandibular molar with C-shaped canal. Endod Dent Traumatol 1986;2:79-81. https://doi.org/10.1111/j.1600-9657.1986.tb00131.x
  18. Varrela J. Effect of 45,X/46,XX mosaicism on root morphology of mandibular premolars. J Dent Res 1992;71:1604-1606. https://doi.org/10.1177/00220345920710091101
  19. Varrela J. Root morphology of mandibular premolars in human 45,X females. Arch Oral Biol 1990;35:109-112. https://doi.org/10.1016/0003-9969(90)90171-6
  20. Kusiak A, Sadlak-Nowicka J, Limon J, Kochanska B. Root morphology of mandibular premolars in 40 patients with Turner syndrome. Int Endod J 2005;38:822-826. https://doi.org/10.1111/j.1365-2591.2005.01023.x
  21. Chauhan R, Singh S, Chandra A. A rare occurrence of bilateral C-shaped roots in mandibular first and second premolars diagnosed with the aid of spiral computed tomography. J Clin Exp Dent 2014;6:e440-e443.
  22. Shah DY. C-shaped root canal configuration in mandibular second premolar: report of an unusual case and its endodontic management. J Int Clin Dent Res Organ 2012;4:18-20. https://doi.org/10.4103/2231-0754.131379
  23. Hunter AJ, Feiglin B, Williams JF. Effects of post placement on endodontically treated teeth. J Prosthet Dent 1989;62:166-172. https://doi.org/10.1016/0022-3913(89)90306-5
  24. Tilk MA, Lommel TJ, Gerstein H. A study of mandibular and maxillary root widths to determine dowel size. J Endod 1979;5:79-82. https://doi.org/10.1016/S0099-2399(79)80153-3
  25. Johnson JK, Schwartz NL, Blackwell RT. Evaluation and restoration of endodontically treated posterior teeth. J Am Dent Assoc 1976;93:597-605. https://doi.org/10.14219/jada.archive.1976.0235
  26. Lim SS, Stock CJ. The risk of perforation in the curved canal: anticurvature filing compared with the stepback technique. Int Endod J 1987;20:33-39. https://doi.org/10.1111/j.1365-2591.1987.tb00586.x
  27. Zuckerman O, Katz A, Pilo R, Tamse A, Fuss Z. Residual dentin thickness in mesial roots of mandibular molars prepared with Lightspeed rotary instruments and Gates-Glidden reamers. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:351-355. https://doi.org/10.1016/S1079-2104(02)91710-5
  28. Jerome CE. C-shaped root canal systems: diagnosis, treatment, and restoration. Gen Dent 1994;42:424-427.
  29. Cooke HG 3rd, Cox FL. C-shaped canal configurations in mandibular molars. J Am Dent Assoc 1979;99:836-839. https://doi.org/10.14219/jada.archive.1979.0402
  30. Haddad GY, Nehme WB, Ounsi HF. Diagnosis, classification, and frequency of C-shaped canals in mandibular second molars in the Lebanese population. J Endod 1999;25:268-271. https://doi.org/10.1016/S0099-2399(99)80157-5

Cited by

  1. Endodontic Management of Dilacerated Maxillary Central Incisor fused to a Supernumerary Tooth using Cone Beam Computed Tomography: An Unusual Clinical Presentation vol.18, pp.6, 2016, https://doi.org/10.5005/jp-journals-10024-2077
  2. PRICE 2020 guidelines for reporting case reports in Endodontics: explanation and elaboration vol.53, pp.7, 2016, https://doi.org/10.1111/iej.13300