Variations of Palatal Canal Morphology in Maxillary Molars: A Case Series and Literature Review

Nosrat, Ali; Verma, Prashant; Hicks, M. Lamar; Schneider, S.; Behnia, Ali; Azim, Adham A.

doi:10.1016/j.joen.2017.04.006

Cited by 16 publications

(14 citation statements)

References 74 publications

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“…Earlier studies provided two clues about the bifurcation of the palatal canal on periapical radiograph: 1) the unusual diverging gutta-percha on the master cone radiograph or the weird divergence of a master apical hand-file on the working-length film [10], 2) the abnormal divergence of root canal filling material which was obturated previously in palatal canal [10]. In this case, the upper first molar undergoing incomplete endodontic treatment with underfilled obturating material in the palatal canal posed an obstacle to discovering the canal morphology.…”

Section: Discussionmentioning

confidence: 99%

“…Once there are signs of the bifurcated palatal canal, clinicians need to re-examine and determine its presence with certainty. On the one hand, according to earlier reports on the case, the canal was only detected after instrumentation with the support of a microscope [6], [10]. More seriously, clinical dentists made a mistake when assuming the palatal root had one canal and one foramen (1-1 anatomy) on the initial periapical film, resulting in failure in the first treatment [10].…”

Section: Discussionmentioning

confidence: 99%

“…This means one orifice for the canal and two distinct apical foramina. Ali Nosrat et al, [10] also presented 5 clinical cases involving the treatment of upper first molar whose canal morphology was far from 1-1 anatomy, four out of which, were classified type V.…”

Section: Introductionmentioning

confidence: 99%

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Endodontic Retreatment of an Upper First Molar with Bifurcated Palatal Canal Using Preoperative Cone-beam Computed Tomography: A Case Report

Chau¹,

Ngọc²,

Duc³

et al. 2019

Open Access Maced J Med Sci

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BACKGROUND: Anatomic variations in palatal canal morphology in maxillary first molars (MFMs) are relatively rare occurrences. Therefore, omission is common unless clinicians recognize their presence. CASE REPORT: The aim of this report is to point out new signs that can be viewed as indicators of the existence of additional canals in the palatal root (PR) in this upper first molar endodontic retreatment case. Moreover, the role of preoperative cone-beam computed tomography (CBCT) in both discovering and determining the location of those additional canals will also be discussed. CONCLUSION: Besides formerly discussed signs that indicate the existence of this canal, clinicians should also pay attention to other signals on periapical radiograph, including the aberrant divergence of a palatal canal at apical third and an unusual lesion occurring laterally in the periapical area of palatal root.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Endodontic Retreatment of an Upper First Molar with Bifurcated Palatal Canal Using Preoperative Cone-beam Computed Tomography: A Case Report

Chau¹,

Ngọc²,

Duc³

et al. 2019

Open Access Maced J Med Sci

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“…The second molars of the upper jaw have the most intricate root canal system in human teeth [ 10 , 11 ]. The rate of occurrence of a secondary mesiobuccal canal (MB2) in permanent second molars of the upper jaw have been reported to be as high as 93.7% [ 12 ], and the likelihood of having two palatal canals was found to range from 1.37% to 6.34% [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Root Anatomy and Root Canal Morphology of Maxillary Second Permanent Molars in a Chongqing Population: A Cone-Beam Computed Tomography Study

et al. 2020

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Background To investigate variations in the anatomy of root canals in permanent second molars of the upper jaw in a population in Chongqing, China, using cone-beam computed tomography (CBCT). Material/Methods CBCT imaging data of 400 second permanent molars of the upper jaws of 200 patients were retrospectively reviewed. Patients’ gender, age, numbers of roots and canals, root fusion of permanent second molars of the maxilla on both sides, and morphological categories of root canals of mesiobuccal roots were recorded. The distances from the apices of the distobuccal and mesiobuccal roots to the buccal bone plate were measured. Results Of the 400 permanent second maxillary molars, 312 (78.0%) had three roots and 247 (61.75%) had three canals. Fused roots were observed in 126 (31.5%) teeth; of these, 67 (53.2%) had three canals and 44 (34.9%) had two canals. Morphologically, 297 (74.25%), 29 (7.25%), nine (2.25%) and 65 (16.25%) teeth had type I, II, III, and IV mesiobuccal root canals, respectively, with 103 (25.75%) having secondary mesiobuccal canals. The distances from the apices of the mesiobuccal, distobuccal, and single buccal roots to the surface of the buccal osseous lamella were 7.34±1.89 mm, 6.26±1.74 mm, and 8.60±2.56 mm, respectively. Conclusions The root form and canal shape of permanent second molars of the upper jaw varied greatly among the population of Chongqing, China. CBCT is a valuable method for assessing the complex anatomic morphology of teeth.

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“…Indeed, many studies have described morphologic variations in maxillary molars, with multiple canals in each root, especially bi-or tri-furcated palatal canals [7][8][9][10][11]. Unusual anatomy in maxillary second molars is often difficult to diagnose because of its posterior location [12]. The superimposition of anatomical structures on conventional radiographs of this tooth may fail to reveal a bifurcated palatal root canal or other anatomical variations, such as single or double roots and fused roots [13,14].…”

Section: Introductionmentioning

confidence: 99%

3D Clinical Evaluation of Unusual Anatomy of A Maxillary Second Molar: A Case Report

Nardo¹,

Gambarini²,

Costantini³

et al. 2018

BJSTR

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Aim To present the combined use of CBCT images and new endodontic software to identify and then facilitate the location and treatment of a canal in an unusually placed second mesio-buccal root of a maxillary left second molar. Summary A 45-year-old female was referred for root canal treatment on her maxillary left second molar tooth (tooth 27). Due to superimposition of the third molar and the position of the tooth that made conventional radiographs unhelpful, a pre-operative limited FOV, Low-Dose Technology™ CBCT image was taken with an OP-300 Maxio™ device (Instrumentarium, Helsinki, Finland). The CBCT images were then imported and analyzed using 3D Endo™ Software (Dentsply Sirona, Wels bei Salzburg, Austria). Within the software, the canal orifices and foramina were located and identified on the display, which allowed the software to automatically reveal and measure the pathway of each canal, which was traced and viewed in both frontal and mesial perspectives. The images revealed the presence of a separate second mesiobuccal root that contained one canal. Root canal treatment was then performed using the information derived from the software. The orifice of the canal in the second MB root was located in an unusual position: 5.99 mm palatally to the main MB canal and 7.57 mm medially from the palatal canal. An immediate post-operative limited FOV, low-dose CBCT was taken to assess the quality of the root filling. After one year the tooth was asymptomatic and radiographic examination revealed no sign of periapical pathosis.

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Variations of Palatal Canal Morphology in Maxillary Molars: A Case Series and Literature Review

Cited by 16 publications

References 74 publications

Endodontic Retreatment of an Upper First Molar with Bifurcated Palatal Canal Using Preoperative Cone-beam Computed Tomography: A Case Report

Endodontic Retreatment of an Upper First Molar with Bifurcated Palatal Canal Using Preoperative Cone-beam Computed Tomography: A Case Report

Root Anatomy and Root Canal Morphology of Maxillary Second Permanent Molars in a Chongqing Population: A Cone-Beam Computed Tomography Study

3D Clinical Evaluation of Unusual Anatomy of A Maxillary Second Molar: A Case Report

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