Management of Bilateral Maxillary Second Molars with Extra Palatal Root: A Case Report

Abstract

A crucial understanding of teeth’ internal and external anatomy is critical for the successful outcome of endodontic therapy. The presence of two palatal roots in maxillary molars, particularly in the second molar is rare. The present case report addresses this anatomical variation in an 18-year-old female patient with a chief complaint of severe pain in the upper left back teeth region since one week. Preoperative radiographic evaluation of maxillary second molar did not reveal the aberrant anatomy due to its location and impaction of maxillary third molar onto the roots of the second molar. After access opening, inspection of the pulp chamber floor revealed a slightly deviated location of the palatal canal and a bleeding point mesial to the palatal canal. Intensive exploration for determining any additional canals was done using David Green (DG) 16 endodontic explorer under 3X magnification using dental loupes. A narrow field of view Cone Beam Computed Tomography (CBCT) was obtained to evaluate the unusual root canal morphology. Following a thorough analysis of CBCT, root canal treatment was performed employing a standard protocol. This case report highlights the successful diagnosis and management of the bilateral maxillary second molar with two separate palatal roots. With CBCT and magnification, determining the root morphology and canal configuration will be more accurate, further improving the quality of root canal treatment.