Mandibular Second Molar with a Single Root and a Single Canal: Case Series

Abstract

CASE REPORTIn this article, we report three cases of endodontic management of a mandibular second molar with a single conical root and a single canal. In all the three cases, a diagnosis of acute irreversible pulpitis was made and the teeth were endodontically treated. Patient's informed consent was obtained in each case before executing the treatment plan. The pre operative radiograph revealed a fused conical root [Table/ Fig-1A]. Hence, multiple preoperative radiographs in various angu lations were taken, that revealed a single root and a single root canal. Standard access cavity was prepared that uncovered a huge canal orifice at the center of the pulp chamber. The canal patency was established with a suitable ISO K file. Working length was determined with the help of electronic apex locater (Root ZX) and confirmed using a radiograph. Cleaning and shaping was done using a step back technique using suitable sized ISO K file. 2.5% sodium hypochlorite solution and saline were used for irrigation and recapitulation. 17% aqueous EDTA solution was used as a final flush. The canals were dried with sterile absorbent points and then coated with AH plus sealer with lentulo-spirals and obturated with gutta-percha using cold lateral compaction technique [Table/ Fig-1B & C]. Follow up was done for 1 year and the patients were found to be asymptomatic.The first case presented a mandibular left second molar. Radiographs of the contralateral and the maxillary second molars also revealed a single fused root. Spiral CT was taken to confirm the radiographic finding, which confirmed the presence of a single root and a single canal in all the four second molars [Table /Fig-2].The second case was a mandibular left second molar. Contralateral and the maxillary left second molar were missing as it was extracted due to dental caries. Maxillary right second molar had three roots. The access cavity was viewed under a surgical operating microscope( Seiler, Revelation) under various magnifications (3X, 5X) and this confirmed the presence of only a single wide canal [Table /Fig-3].The third case was a mandibular right second molar. Radiographs of the contralateral and the maxillary second molars and the panoramic radiograph revealed a single fused root [Table /Fig-4]. ABSTRACTThe 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.

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

“…Assessment of preoperative periapical radiographs demonstrated the presence of one root with a large canal space suggesting the likelihood of C-shaped canal configuration. In fact, when only one root is present, the root canal system may contain only a single large canal or two root canals that may or may not join within the canal system or a C-shaped canal configuration [18]. However, systematic evaluation of CBCT slices revealed the presence of one large round canal.…”

A novel system for classifying tooth root phenotypes

“…Like tooth crowns, roots exhibit considerable variability in number, morphology, and size. For example, premolars have been reported as having between one to three roots [3,4], while maxillary and mandibular molars have between one and five roots [5][6][7][8]. The literature has also long recognized several unusual morphological variants such as Tomes' root [9], taurodont roots [10], and C-shaped roots [11].…”

Manejo clínico endodóntico de la variación anatómica conducto en “C” tipo IV en un segundo molar mandibular

“…El segundo molar mandibular frecuentemente tiene dos raíces, una mesial y otra distal, habitualmente con dos conductos mesiales; mesiobucal (MB) y mesiolingual (ML) y un conducto distal similar a los primeros molares mandibulares, generalmente sus raíces están más juntas, y en muchos casos fusionadas [1][2][3] .…”

“…La tomografía computarizada Cone Beam (CBCT) ha sido ampliamente utilizada en endodoncia en los últimos años debido a su mayor resolución y exploración, así como el tiempo y dosis de radiación reducida 2,7 . Sin embargo, la Asociación Americana de Endodoncia (AAE) y la Academia Americana de Radiología Oral y Maxilofacial (AAOMR), mencionado por Kato et al 7 establecen que CBCT sólo debe utilizarse cuando la radiografía dental convencional no permita el diagnóstico adecuado.…”