Introduction. Maxillary first molars have shown substantial dissimilarity
regarding their number of roots, canals and morphology. Most commonly, it has
three roots and four canals, two mesiobuccal, one distobuccal and one palatal
canal. The incidence of second mesiobuccal canal has been reported between
18% and 96.1% while the incidence of two distobuccal canals was found in
1.64% to 9.50% of cases. Periapical (PA) radiography has been commonly used
to determine root canal anatomy even though it is two-dimensional
representation of a three-dimensional object. Advanced diagnostic methods as
spiral computed tomography (SCT) provide three-dimensional images useful to
determine complex canal morphology. Case Report. A 31-year-old male patient
was referred for endodontic treatment of the maxillary right first molar.
Endodontic access cavity revealed two canal openings in each of the
mesiobuccal and distobuccal roots and one canal in the palatal root later
confirmed using the SCT and conventional PA radiography. The canals were
instrumented using crown down technique with ProTaper NiTi rotary files.
Obturation was performed using single gutta-percha cone and AH Plus paste.
The patient remained asymptomatic during the regular checkups. Conclusion.
Knowledge, detection and management of complex canal anatomy is of the
foremost importance in endodontics since missed canals are one of well
recognised reasons for endodontic treatment failure.
Expansion of Gutta-percha in contact with various concentrations of zinc oxide-eugenol sealer: A three-dimensional volumetric study using spiral computed tomography