Abstract
Endodontic treatment may sometimes fail because morphological features of the tooth adversely affect the treatment protocol. Maxillary second molars are recognized as usually having a single palatal root with a single palatal canal. The incidence of second palatal root in the maxillary second molar is very rare. Two cases are presented in this paper describing the endodontic management of a four-rooted maxillary second molar with two distinct palatal roots and canals and two distinct buccal roots and canals. Clinical examination and radiographs showed the presence of two palatal roots during the root canal procedure. The canals were biomechanically prepared with crown-down technique and obturated using lateral condensation technique with AH-Plus sealer.
Highlights
The main objective of root canal treatment is the thorough mechanical and chemical debridement of the entire pulp space followed by complete obturation with an inert filling material
It is imperative that aberrant anatomy is identified prior to and during root canal treatment
A clear understanding of the root canal anatomy of the human dentition and its variations is a prerequisite for successful endodontic procedures
Summary
The main objective of root canal treatment is the thorough mechanical and chemical debridement of the entire pulp space followed by complete obturation with an inert filling material. It is imperative that aberrant anatomy is identified prior to and during root canal treatment. A clear understanding of the root canal anatomy of the human dentition and its variations is a prerequisite for successful endodontic procedures. Al Shalabi et al [1], Green [2], and Vertucci [3] did not notice any maxillary second molars with two palatal root canals in their respective studies. Libfeld and Rotstein [4] reported a 0.4% incidence of four rooted maxillary second molars among 1200 teeth studied. This paper describes two cases of unusual variation in root and canal morphology of four-rooted maxillary second molar with two buccal and two palatal canals and their endodontic management
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