OBJECTIVES The aim of this case report is to present clinical management of failed root canal treatment of a maxillary second molar with an unusal anatomy. Also, to emphasize on the importance of using recent technologies like Dental Operating Microscope (DOM) and ultrasonic tips in improving treatment outcomes. MATERIALS AND METHODS A 32-year-old male patient was referred for evaluation and possible retreatment of his right maxillary second molar (tooth number 17). The root canal retreatment was carried out using NiTi rotary files under the use of dental operating microscope and with the help of ultrasonic tips. Obturation was done using thermal technique. A 9 years follow up CBCT was taken and analyzed using advanced software. DISCUSSION The molar presented in this study had a particular morpholgy (which was undetected by the previous RCT). The particularity of this molar is the presence of four roots and five root canals (one canal in each root except in the mesio-buccal root that had MB1 and MB2). In addition to the mesio-buccal, disto-buccal and palatal roots, found in almost every maxillary second molar, this tooth had an extra auxillary small root located in the center of the pulp chamber which had a separate root canal. The use of Dental Operating Microscope during access opening is important to search for hidden and supernumerary canals if present. Also the use of modern technologies like ultrasonic tips is a great aid in locating these canals. CONCLUSIONS The success of endodontic treatment depends on identifying, exploring and completely treat all the root canal complicated systems. This can be achieved with proper knowledge as well as exploring the anticipated variations using recent technologies.

Clinical case of non surgical endodontic retreatment of maxillary second molar with unusual anatomy

Amato, Massimo;
2017-01-01

Abstract

OBJECTIVES The aim of this case report is to present clinical management of failed root canal treatment of a maxillary second molar with an unusal anatomy. Also, to emphasize on the importance of using recent technologies like Dental Operating Microscope (DOM) and ultrasonic tips in improving treatment outcomes. MATERIALS AND METHODS A 32-year-old male patient was referred for evaluation and possible retreatment of his right maxillary second molar (tooth number 17). The root canal retreatment was carried out using NiTi rotary files under the use of dental operating microscope and with the help of ultrasonic tips. Obturation was done using thermal technique. A 9 years follow up CBCT was taken and analyzed using advanced software. DISCUSSION The molar presented in this study had a particular morpholgy (which was undetected by the previous RCT). The particularity of this molar is the presence of four roots and five root canals (one canal in each root except in the mesio-buccal root that had MB1 and MB2). In addition to the mesio-buccal, disto-buccal and palatal roots, found in almost every maxillary second molar, this tooth had an extra auxillary small root located in the center of the pulp chamber which had a separate root canal. The use of Dental Operating Microscope during access opening is important to search for hidden and supernumerary canals if present. Also the use of modern technologies like ultrasonic tips is a great aid in locating these canals. CONCLUSIONS The success of endodontic treatment depends on identifying, exploring and completely treat all the root canal complicated systems. This can be achieved with proper knowledge as well as exploring the anticipated variations using recent technologies.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11386/4708425
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