Four second molars with single roots and single canals in the same patient

Worldwide Prevalence of Single-rooted with a Single Root Canal and Four-rooted Configurations in Maxillary Molars: A Multi-center Cross-sectional Study with Meta-analysis

INTRODUCTION

To evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes.

METHODS

Researchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%.

RESULTS

The prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (P < .05) and higher percentages of four-rooted configurations (P > .05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (P > .05).

CONCLUSIONS

The proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar.

Diving Deep: Exploring Dual Palatal Canals in the Upper Second Molar

Dental anatomy exhibits considerable variation with the presence of additional canals being a common occurrence. The upper second molar typically presents with three canals and three roots; however, variations such as the existence of an extra canal or a root can pose challenges during endodontic treatment. Maxillary molar is characterized by an additional canal located within the palatal root, often exhibiting complex configurations and variations in morphology. Access refinement is critical to gaining adequate visibility and facilitating instrumentation. Meticulous exploration of the pulp chamber floor and careful examination of radiographs from different angles are essential for accurate diagnosis. Careful negotiation and cleaning of the extra canal with appropriate files and irrigants are essential to remove pulp tissue and debris effectively. Furthermore, obturation of the canal space with biocompatible materials is crucial to ensure a three-dimensional seal and prevent bacterial ingress. Clinically, the inability to detect and treat the extra palatal canal can lead to persistent infection, incomplete debridement, and compromised treatment outcomes. This case report delves into the significance of this anatomical variation, diagnostic modalities, and effective management strategies.

A Single Canal in a Mandibular Second Molar: A Case Report

Root canal anatomy of mandibular second molars differs among individuals. With the aid of the latest dental technologies in endodontics, the present case report highlights the diagnostic tools required to confirm the morphology of the root canal, and the treatment of uncommon root anatomy of a single-canal single-rooted mandibular second molar. Clinicians should be aware of the various anatomic variations that each tooth may present in order to achieve a satisfactory result. Furthermore, in order to improve the quality of care delivered to their patients, practitioners must have the necessary knowledge and abilities to utilize the diagnostic and therapeutic instruments at their disposal.

A Rare Case of Single-Rooted Mandibular Second Molar with Single Canal

The root canal anatomy of mandibular second molar teeth is known to be highly variable. Whilst the most frequently seen configuration is two mesial canals and one distal canal, other variations such as four canals, two canals, and C-shaped canal system do also exist. This case report describes the diagnosis and management of unusual root canal configuration of a mandibular second molar, with one canal in a single conical root, using the contemporary advancements in endodontics. Following clinical and radiographic examinations of the case, a diagnosis of symptomatic irreversible pulpitis with symptomatic apical periodontitis of tooth #47 was established, and root canal treatment followed by composite buildup and crown were planned. Clinicians should be aware of the different anatomic variants each tooth may exhibit. Furthermore, clinicians need to possess the proper knowledge and skills that allow them to utilize the diagnostic and therapeutic tools available at their disposal in order to optimize the quality of care provided to their patients.

Endodontic Management of Maxillary Second Molar Tooth with a Single Root and Single Canal

Comprehensive understanding of variations in the root canal morphology of a maxillary molar is useful for performing successful endodontic treatment in such cases. This case report describes endodontic management of a case with such aberrant root canal morphology of a maxillary second molar having a single root and single canal.

A rare case of three single rooted permanent second molars: A diagnosis with cone beam computed tomography (CBCT)

The aim of this article is to present a case with an unusual morphology of maxillary second molars on both sides and a mandibular second molar on right side in the same patient which was observed during routine endodontic procedure. Three second permanent molars had single root, single canal and an accurate assessment of this unusual morphology was made with the help of radiographs and cone beam computed tomography (CBCT). This report extends the range of known possible anatomical variations to include teeth with lesser number of roots and canals.

Maxillary Second Molar with Fused Root and Six Canals- A Case Report

One of the known aberrations in root canal morphology of maxillary second permanent molars is the presence of collateral mesiobuccal canals. This case report describes the endodontic management of a maxillary second molar that had a single fused root with six canals that was successfully managed with the aid of dental operating microscope. Six canal orifices were located namely MB1 (Mesiobuccal), MB2, MB3, DB1 (Distobuccal), DB2 and palatal. During the cleaning and shaping, instrument separation occurred at the apical third of the palatal canal which was removed with ultrasonics. After cleaning and shaping, the canals were obturated with resin sealer and laterally condensed gutta-percha. The patient was recalled for periodic review. After two years of follow up the patient remained asymptomatic. Cone Beam Computed Tomography (CBCT) evaluation revealed satisfactory periapical status.

Single Rooted Permanent Premolars and Molars - A Rare Clinical Presentation Confirmed using Cone Beam Computed Tomography

The morphology of the root and root canal system plays a significant role in the treatment outcome of endodontic procedures. The necessity of clear and high contrast images for tissues like bone and teeth has made the usage of newer imaging techniques inevitable. This is a rare case report wherein, the permanent posterior dentition of both arches was single rooted. While sporadic cases of single rooted teeth have been reported, it is rare for all the premolars and molars to show such variation. This rare clinical observation has been enhanced by Cone Beam Computed Tomography (CBCT), which provides a clear image with added benefits of 3D (Three Dimensional) image reconstruction, low dosage and rapid scan time.

Single C-shaped canal in mandibular first molar: A case report

The variability of root canal system morphology presents a continuous challenge to endodontic diagnosis and therapeutics. There have been reports of teeth with multiple roots and canals as also those with lesser number of root and root canals. Variations of root canal systems need not always be in the form of extra canals. Clinicians should be aware that there is a possibility of existence of fewer numbers of roots and root canals than normal, which presents varied canal anatomy and poses a challenge to the clinician's expertise. This case report deals with the management of an unusual case of C-shaped canal in mandibular molar with two buccally fused roots. Cone-beam computed tomography (CBCT) was employed to confirm the extension of the unusual anatomy. The Self Adjusting File (SAF) system was used to ensure complete cleaning of the canal system. One-year follow-up of the case showed good healing. The clinician should expect to encounter unusual features when performing endodontic treatment. Use of diagnostic aids like CBCT, improved magnification with dental operating microscope, and the use of novel file systems like SAF ensure success.

Aetiology, incidence and morphology of the C-shaped root canal system and its impact on clinical endodontics

The C-shaped root canal constitutes an unusual root morphology that can be found primarily in mandibular second permanent molars. Due to the complexity of their structure, C-shaped root canal systems may complicate endodontic interventions. A thorough understanding of root canal morphology is therefore imperative for proper diagnosis and successful treatment. This review aims to summarize current knowledge regarding C-shaped roots and root canals, from basic morphology to advanced endodontic procedures. To this end, a systematic search was conducted using the MEDLINE, BIOSIS, Cochrane Library, EMBASE, Google Scholar, Web of Science, PLoS and BioMed Central databases, and many rarely cited articles were included. Furthermore, four interactive 3D models of extracted teeth are introduced that will allow for a better understanding of the complex C-shaped root canal morphology. In addition, the present publication includes an embedded best-practice video showing an exemplary root canal procedure on a tooth with a pronounced C-shaped root canal. The survey of this unusual structure concludes with a number of suggestions concerning future research efforts.

Single-rooted primary first mandibular molar

Morphological variations like single-rooted molar in primary dentition are scarce. Understanding the root canal anatomy and variations is necessary for successful root canal therapy. The purpose of the present article is to report successful endodontic treatment of primary left mandibular first molar with an abnormal morphology of a single root. This case report highlights the importance of knowledge and its applications in the management of anomalous anatomic variants which play a crucial role in the success of endodontic treatment.

Mandibular first molar with a single root and single canal

Successful endodontic management of mandibular first molar with a single root and single canal is diagnosed with the aid of dental operating microscope and multiple angled radiographs. In addition all the mandibular molars and premolars were single rooted on either side.

Mandibular second molar with a single root and a single canal: case series

The variability of root canal system morphology of multirooted teeth represents a continuous challenge to endodontic diagnosis and therapeutics. This report extends the range of known possible anatomical variations to include teeth with lesser number of root and root canals. Variations of root canal systems need not always be in the form of extra canals. Clinicians should be aware that there is a possibility of existence of fewer number of roots and root canals than the normal root canal anatomy. Thus the aim of this article is to present three cases of endodontically managed mandibular second molars with a single root and root canal.

Asymmetry in mesial root number and morphology in mandibular second molars: a case report

Ambiguity in the root morphology of the mandibular second molars is quite common. The most common root canal configuration is 2 roots and 3 canals, nonetheless other possibilities may still exist. The presence of accessory roots is an interesting example of anatomic root variation. While the presence of radix entomolaris or radix paramolaris is regarded as a typical clinical finding of a three-rooted mandibular second permanent molar, the occurrence of an additional mesial root is rather uncommon and represents a possibility of deviation from the regular norms. This case report describes successful endodontic management of a three-rooted mandibular second molar presenting with an unusual accessory mesial root, which was identified with the aid of multiangled radiographs and cone-beam computed tomography imaging. This article also discusses the prevalence, etiology, morphological variations, clinical approach to diagnosis, and significance of supernumerary roots in contemporary clinical dentistry.

A new anatomically based nomenclature for the roots and root canals-part 2: mandibular molars

Several terminologies have been employed in the dental literature to describe the roots and root canal systems of mandibular molars with no consensus being arrived at, thus far. The anatomical relation of roots and their root canals were identified and a naming system was formulated. The proposed nomenclature attempts to make certain essential modifications to the traditional approach to accommodate the naming of various aberrations presented in mandibular molars. A simple, yet extensive nomenclature system has been proposed that appropriately names the internal and external morphology of mandibular molars.

Maxillary right second molar with two palatal root canals

We report a clinical case of maxillary right second molar with two palatal root canals. The morphology is atypical because it is characterized by two palatal roots with two canals with widely separated orifices and canals. Modifications to the normal access opening and examination of the pulpal floor for additional canals are stressed.

Maxillary second molar with 5 roots and 5 canals evaluated using cone beam computerized tomography: a case report

This case report presents the endodontic management of maxillary right second molar exhibiting 5 roots and 5 root canals. The diagnosis was confirmed with the help of cone beam computerized tomography (CBCT). The article also describes the varied morphology associated with maxillary second molar and the use of a high-end diagnostic imaging modality like CBCT in diagnosing and negotiating these anatomic variations.

Treatment of a second maxillary molar with six canals

Variations in the dental anatomy are found in all teeth. Knowledge of these variations, particularly concerning the location and treatment of all canals, is very important for the success of the endodontic therapy. The purpose of this study is to present a clinical case of a maxillary second molar with three palatal canals, two mesio-buccal and one disto-buccal canal. This report serves to remind clinicians that such anatomical variations should be taken into account during endodontic treatment of the maxillary molars.

Spiral computed tomographic demonstration of C-shaped canals in mandibular second molars

OBJECTIVES

The aim of this study was to evaluate the prevalence of C-shaped canals in single rooted mandibular second molars with spiral computed tomographic imaging in detail.

METHODS

One hundred and twelve single-rooted mandibular second molar samples were selected from 491 extracted mandibular second molars. The teeth were scanned by spiral computed tomographic technique to examine canal configurations.

RESULTS

The evaluation criteria of the shape of roots was based on Manning's category as round, oval and C-shaped. The prevalence of C-shaped canals was found to be 8.1% in mandibular second molars. The evaluation of the root canal configurations of C-shaped mandibular second molars with single roots (40 teeth) was based on Vertucci's classification. Vertucci type I canals were most frequently seen in C-shaped mandibular second molars (40%). Additionally, we disclosed three additional canal types.

CONCLUSION

Results of this study demonstrated that high resolution visualization of the root canal shape can be achieved by spiral computed tomographic imaging.