Successful Non-surgical Endodontic Management Research Articles

Endodontic management of a maxillary first molar with three roots and six root canals

Variations in the root canal anatomy of a maxillary first molar are often challenging to diagnose and treat; thus, clinicians must have a thorough knowledge of the same. This case report highlights the successful nonsurgical endodontic management of a maxillary first molar with an unusual morphology of three roots and six root canals. A total of six root canals (mesiobuccal [MB] 1, MB2, MB3, distobuccal [DB] 1, DB2, and palatal) were detected after initiating root canal therapy and access cavity preparation. Conventional root canal treatment was completed, and postoperative cone-beam computed tomography scanning was done to verify the total number of canals and ensure the adequacy of root canal fillings. Managing such cases with rare variations in the root canal systems could be arduous and thus, clinicians should be well-versed in the methods to identify and manage such complexities to facilitate the successful outcomes of endodontic treatment.

A Cone-beam Computed Tomography-guided Endodontic Management of Internal Variations in the Root Canal Anatomy of Maxillary Molar

This case report aims to present and analyze the internal variations in root canal anatomy of a maxillary molar and its successful non-surgical endodontic management using CBCT guidance. This clinical report aims to emphasize the importance of recognizing atypical dental internal anatomy during endodontic treatment and to describe a case where the presence of two palatal roots in the maxillary molar was identified and was managed successfully. This report presents a case where endodontic treatment was performed on a maxillary molar with unusual pulpal and periapical findings. During the treatment, the presence of two palatal roots in the tooth was observed, and relevant treatment modalities were discussed for the treatment’s success. Understanding the internal anatomy of teeth is crucial in clinical and radiographic examinations. This knowledge is essential for detecting unusual roots and canals and ensuring effective cleaning and shaping of calcified canals, which are often overlooked in endodontic treatment.

Successful non-surgical endodontic management of type III dens invaginatus by using cone-beam computed tomography: a case report

Dens invaginatus (DI) is a rare malformation of a tooth caused by the invagination of tooth crown before biological mineralization occurs. In DI type III invagination extends beyond the cementum-enamel junction, with the second foramen extending into the periapical tissues or into the periapical area. DI type III may pose real challenges for the clinician, especially when endodontic treatment is required. Objective: The present case report describes the successful non-surgical endodontic management of a tooth with DI type III with the aid of cone-beam computed tomography (CBCT). Case report: A 20-year-old male patient was referred for endodontic evaluation and treatment of the left maxillary lateral incisor (tooth #22), which presented a darker and unusual crown shape. Periapical radiography and CBCT scans revealed the presence of a type III DI, and a larger periapical lesion associated with external root resorption and discontinuous buccal cortical plate Results: The diagnosis of Oehlers type III DI with asymptomatic apical periodontitis was established, and non-surgical endodontic treatment was initiated. After 5 months, a decrease in the periapical lesion and arrest of external resorption was detected. The root canals were then filled, and the tooth restored. At the 3-years follow-up, clinical and imaging assessments revealed successful outcome of the treatment. Conclusion: CBCT is an inestimable tool for non-surgical endodontic management of teeth with complex internal anatomy, such as DI type III with associated large periapical lesion.

Successful nonsurgical endodontic management of fused paramolar to maxillary second molar with the aid of spiral computed tomography - Two rare case reports

The aim of this article is to present two rare case reports of successful non surgical endodontic management of permanent maxillary second molar fused with a paramolar. In the present cases, we have used spiral computed tomography for better understanding of the complicated external and internal morphology of the fused tooth and successful nonsurgical endodontic management was done.

Cone beam computed topographic evaluation and endodontic management of a rare mandibular first molar with four distal canals.

Root canal system is complex to understand because of its unpredictable nature. It differs for different teeth and for the same teeth in different individuals. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these variations. A mandibular first molar with six root canals represents a rare anatomical variant, particularly when four canals are found in distal root. This case report discusses successful nonsurgical endodontic management of two-root mandibular first molar with four distal canals and two mesial canals reported for the first time in Indian population. Cone beam computed tomography was used as a diagnostic method to confirm the position and presence of 4 root canals in the distal root.

Endodontic Management of Mandibular Incisors with Type III and IV Canals: A Case Report

Successful endodontic therapy depends on accurate diagnosis, thorough chemo-mechanical preparation and three dimensional obturation. Mandibular incisor's anatomy presents a challenge when making endodontic access because of its small size and high prevalence of two canals. This case report is presented to illustrate the serendipitous discovery and successful non-surgical endodontic management of complex canal systems in mandibular incisors. Modification of access preparation and alternative preparation between canals are necessary to avoid complication and failure.

Endodontic management of mandibular central incisor fused to a supernumerary tooth associated with a talon cusp: a case report

To report the successful non-surgical endodontic management of a mandibular central incisor fused to a supernumerary tooth associated with a talon cusp. Fusion and gemination are developmental anomalies of teeth that may require endodontic treatment. In this article, a case of successful endodontic management of a permanent mandibular right central incisor fused to its supernumerary counterpart associated with a talon cusp is reported. The incidence of fusion in mandibular anteriors is rare. A search of the literature failed to reveal any reports on the fusion of a permanent mandibular central incisor with its supernumerary counterpart associated with a talon cusp. Successful non-surgical endodontic management of a case is reported. •  Fused and geminated teeth requiring endodontic treatment present diagnostic and technical challenges. • An exact differentiation between fusion and gemination may not be critically important for treatment. • The use of an operating microscope for detection of additional root canal orifices in complicated cases is recommended.

Four-Rooted Mandibular First Molar with an Unusual Developmental Root Fusion Line: A Case Report

The paper describes the anatomical variation of four roots in a mandibular permanent first molar diagnosed using multiple angulated preoperative radiographs and its successful nonsurgical endodontic management. Careful observation and exploration of the pulpal floor using a dental operating microscope revealed a peculiar developmental root fusion line on the pulp chamber floor. Based on the above observation, a correlation between this unusual line and the existence of additional roots has been proposed and discussed.

3-D diagnosis-assisted management of anomalous mandibular molar

This case report describes the successful non-surgical endodontic management of carious exposed three-rooted mandibular molar with four root canals detected on the pre-operative radiograph taken with 20 degrees mesial angulation and confirmed with a 64-slice helical computed tomography scan-assisted 3-D-reconstructed images. Access cavity shape was modified to locate the extra canal with respect to the distolingual root in the left mandibular first molar. Copious irrigation was accomplished with 5.25% sodium hypochlorite and 17% EDTA. Biomechanical preparation was done using protapers. Calcium hydroxide dressing was done for 1 week. The tooth was obturated using gutta percha and AH 26 root canal sealer, and it was permanently restored with composite. Clinical examination on follow-up visits revealed no sensitivity to percussion and palpation in the left mandibular first molar. Thorough knowledge of root canal variations and use of advanced diagnostic modalities lead to successful non-surgical management of the complex cases.

A maxillary lateral incisor with four root canals

To describe the successful non-surgical endodontic management of a permanent maxillary lateral incisor tooth with four root canals. Aberrant morphology of root canals can occur in any tooth, including maxillary lateral incisors. In the presented case, clinical examination and radiographs clearly depicted the presence of four root canals in a right maxillary lateral incisor. The differential diagnosis included fusion, gemination, dens invaginatus or a combination of these. The report emphasises the need for attention during root canal treatment of maxillary lateral incisors. • Clinicians should be aware of the variable root canal anatomy in maxillary lateral incisor teeth. • Careful examination of radiographs and the internal anatomy of teeth are essential prerequisites for successful root canal treatment. • Four root canals in maxillary lateral incisors is a possibility.

Endodontic Management of a Mandibular Second Premolar with Four Roots and Four Root Canals with the Aid of Spiral Computed Tomography: A Case Report

Aberrations in the root canal anatomy are a commonly occurring phenomenon. A thorough knowledge of the basic root canal anatomy and its variations is necessary for successful completion of the endodontic treatment. Mandibular second premolars usually have a single root and a single root canal. The incidence of three separate roots itself in this tooth is quite rare, and the presence of four separate roots and four distinct root canals has never been reported in literature so far. The use of spiral computed tomography scan in this rare case greatly contributed towards making a confirmatory diagnosis and successful nonsurgical endodontic management thereafter.

Endodontic treatment of mandibular incisors with two root canals: Report of two cases

The root canal anatomy of mandibular incisors can present a number of variations, including multiple canals. Two case reports are presented to illustrate the serendipitous discovery and successful non-surgical endodontic management of complex canal systems in mandibular incisors. In both cases, all four mandibular incisors had two canals each.