Restor Dent Endod.  2012 Aug;37(3):175-179. 10.5395/rde.2012.37.3.175.

Endodontic management of a C-shaped maxillary first molar with three independent buccal root canals by using cone-beam computed tomography

• Karanxha L
• Kim HJ
• Hong SO
• Lee W
• Kim PS
• Min KS

• KMID: 1995659
• DOI: http://doi.org/10.5395/rde.2012.37.3.175

Abstract

The aim of this study was to present a method for endodontic management of a maxillary first molar with unusual C-shaped morphology of the buccal root verified by cone-beam computed tomography (CBCT) images. This rare anatomical variation was confirmed using CBCT, and nonsurgical endodontic treatment was performed by meticulous evaluation of the pulpal floor. Posttreatment image revealed 3 independent canals in the buccal root obturated efficiently to the accepted lengths in all 3 canals. Our study describes a unique C-shaped variation of the root canal system in a maxillary first molar, involving the 3 buccal canals. In addition, our study highlights the usefulness of CBCT imaging for accurate diagnosis and management of this unusual canal morphology.

Keyword

Anatomical variation; CBCT; C-shaped; Maxillary first molar

MeSH Terms

Cone-Beam Computed Tomography
Dental Pulp Cavity
Floors and Floorcoverings
Molar

Figure

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  Figure 1 (a) Preoperative periapical radiograph of the maxillary left first molar; (b) One file was placed in the mesiobuccal area and one in the palatal canal. However, when digital image was acquired, the file seemed to be inserted between the mesiobuccal and distobuccal roots. Thus, we feared that the file closer to the distal might have resulted in a perforation (white arrow).

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  Figure 2 Transverse cone-beam computed tomography (CBCT) sections of the maxillary first molar indicate 'C-shaped' or 'horseshoe-shaped' buccal root. The second mesiobuccal canal is not obvious in these sections because of calcification.

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  Figure 3 (a) Access cavity showing 3 separate buccal canal orifices, which are connected by isthmuses (white arrows); (b) Posttreatment periapical radiograph showing 3 distinct and independent buccal canals throughout their course. MB, mesiobuccal canal; MB-2, second mesiobuccal canal; DB, distobuccal canal.

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