Restor Dent Endod.  2015 May;40(2):161-165. 10.5395/rde.2015.40.2.161.

Use of cone-beam computed tomography and three-dimensional modeling for assessment of anomalous pulp canal configuration: a case report

• Sinanoglu
• Helvacioglu-Yigit D
• Mutlu I

• KMID: 2148867
• DOI: http://doi.org/10.5395/rde.2015.40.2.161

Abstract

Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year-old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.

Keyword

Cone-beam computed tomography; C-shaped canal; Fused root; Mandibular second premolar; Three-dimensional modeling

MeSH Terms

Appointments and Schedules
Bicuspid
Cone-Beam Computed Tomography*
Dental Pulp Cavity*
Female
Gutta-Percha
Humans
Pathology
Tooth
Gutta-Percha

Figure

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  Figure 1 (a) Pre-operative periapical radiograph; (b) Intra-operative periapical radiograph; (c) Post-operative periapical radiograph; (d) 12 months follow-up periapical radiograph of the case.

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  Figure 2 Axial sectional images revealed by CBCT. Note the 4 separate canal configurations marked by circle.

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  Figure 3 (a) Sagittal image of the root; (b) Axial image at the apical third presenting a C-shaped canal configuration; (c) Cross-sectional three-dimensional reconstruction demonstrating 4 separate canals.

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  Figure 4 Three-dimensional modeling of the internal and external root canal morphology. Internal view (red) shows the separate root canal configuration, and the external view (blue) presents fused formation of the anomalous root.

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