Multiple root canals in the maxillary molar: an unusual case report

Abstract Background The objective of this report was to highlight the importance of using a dental operating microscope (DOM) to locate supernumerary canals and diagnose variations in root canals using cone-beam computed tomographic (CBCT) images. Case presentation A 35-year-old Chinese female had repeated swelling in the upper right posterior maxilla for 3 months and was referred to evaluate symptomatic apical periodontitis and mesotaurodonts for upper right first permanent molar and upper right second permanent molar. Root canal therapy was proposed and conducted with the use of DOM and CBCT. Conclusions Proper diagnosis and careful clinicoradiological examination are necessary, and it is essential to reinforce the knowledge of the rare morphology of root canals for clinicians.

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Endodontic treatment of mandibular canine with two canals

Биомедицинска истраживања ◽

10.5937/bii2002183n ◽

2020 ◽

Vol 11 (2) ◽

pp. 183-187

Author(s):

Dajana Nogo-Živanović ◽

Dragan Ivanović ◽

Tanja Ivanović ◽

Marina Radanović ◽

Biljana Vasiljević ◽

...

Keyword(s):

Root Canal ◽

Endodontic Treatment ◽

Radiographic Examination ◽

Canal System ◽

Root Canal Therapy ◽

Case Presentation ◽

Morphological Variations ◽

Root Canals ◽

Mandibular Canine ◽

Low Incidence

Introduction. Success in endodontic treatment depends upon the clinician's knowledge and ability to recognize and diagnose the presence of anatomical and morphological variations of the root and canal system. Mandibular canines are usually recognized as having one root and one root canal. In spite of the low incidence of mandibular canines with one root and two canals, their appearance should not be neglected due to the fact that the presence of a second canal in these teeth leads to difficulties in endodontic treatment. The aim of this case report is to describe mandibular canine with two root canals. Case presentation. 45-year-old patient presented for medical care due to the pain in a lower right canine. Clinical and radiographic examination revealed composite filling and caries with periapical radiolucent area and sensitivity to percussion in the mandibular right canine. By careful evaluation of the diagnostic radiology, it was observed that the mandibular canine had two canals. The patient was diagnosed with acute apical periodontitis and root canal therapy was given following the standard protocols. Conclusion. Although the prevalence of two canals in mandibular canine is low, the clinician should always be mindful of variations in the number of canals for appropriate therapeutic management.

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Micro-tomographic characterization of the root and canal system morphology of mandibular first premolars in a Chilean population

Scientific Reports ◽

10.1038/s41598-020-80046-1 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Alfredo Sierra-Cristancho ◽

Luis González-Osuna ◽

Daniela Poblete ◽

Emilio A. Cafferata ◽

Paola Carvajal ◽

...

Keyword(s):

Root Canal ◽

Multiple Root ◽

Root Anatomy ◽

Type I ◽

Micro Computed Tomography ◽

Canal System ◽

Root Canals ◽

Wide Range ◽

Root Canal System ◽

Chilean Population

AbstractThis study aimed to analyze the root anatomy and root canal system morphology of mandibular first premolars in a Chilean population. 186 teeth were scanned using micro-computed tomography and reconstructed three-dimensionally. The root canal system morphology was classified using both Vertucci’s and Ahmed’s criteria. The radicular grooves were categorized using the ASUDAS system, and the presence of Tomes’ anomalous root was associated with Ahmed’s score. A single root canal was identified in 65.05% of teeth, being configuration type I according to Vertucci’s criteria and code 1MP1 according to Ahmed’s criteria. Radicular grooves were observed in 39.25% of teeth. The ASUDAS scores for radicular grooves were 60.75%, 13.98%, 12.36%, 10.22%, 2.15%, and 0.54%, from grade 0 to grade 5, respectively. The presence of Tomes’ anomalous root was identified only in teeth with multiple root canals, and it was more frequently associated with code 1MP1–2 of Ahmed’s criteria. The root canal system morphology of mandibular first premolars showed a wide range of anatomical variations in the Chilean population. Teeth with multiple root canals had a higher incidence of radicular grooves, which were closely related to more complex internal anatomy. Only teeth with multiple root canals presented Tomes’ anomalous root.

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Case Report. Extracorporeal Membrane Oxygenation in Nivolumab Associated Pneumonitis

The Journal of Critical Care Medicine ◽

10.1515/jccm-2017-0013 ◽

2017 ◽

Vol 3 (2) ◽

pp. 84-88

Author(s):

Thomas-Michael Schneider ◽

Friederike Klenner ◽

Franz Brettner

Keyword(s):

Case Report ◽

Extracorporeal Membrane Oxygenation ◽

Therapeutic Option ◽

High Dose ◽

Great Success ◽

Case Presentation ◽

Computed Tomographic ◽

Rehabilitation Hospital ◽

Membrane Oxygenation ◽

History Of

Abstract Background: Newly approved immunotherapeutic agents, like CTLA-4 inhibitors and antibodies against PD-1, are a promising therapeutic option in cancer therapy. Case presentation: A 74-year-old man, with a history of advanced stage melanoma and treatment with ipilimumab, pembrolizumab and nivolumab, was admitted to the hospital due to respiratory failure with hypoxemia and dyspnoea. He rapidly developed severe acute respiratory distress syndrome (ARDS), which required treatment in the intensive care unit which included mechanical ventilation and extracorporeal membrane oxygenation (ECMO). Computed tomographic imaging (CT) showed signs of a pneumonitis, with an ARDS pattern related to the use of PD-1 antibodies. Treating the patient with high-dose immunosuppressive steroids led to an overall improvement. He was transferred to a rehabilitation hospital and subsequently to his home. Discussion and conclusion: This is a unique case report of a patient suffering a grade 4 adverse event under nivolumab who survived having been treated with ECMO. It highlights the possibility of associated adverse reactions as well as the use of ECMO in palliative care patients. ECMO can be of great success even in patients with malignancies, but careful decision making should be done on a case by case basis.

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Use of Cone Beam Computed Tomography to Identify the Morphology of Maxillary and Mandibular Premolars in Chennai Population

Brazilian Dental Science ◽

10.14295/bds.2019.v22i1.1673 ◽

2019 ◽

Vol 22 (1) ◽

pp. Process

Author(s):

Rajamohan Rajakeerthi ◽

Malli Suresh Babu Nivedhitha

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Root Canal ◽

Treatment Success ◽

Cone Beam ◽

Type I ◽

Root Canals ◽

Computed Tomographic ◽

Root Canal Anatomy ◽

Computed Tomography Scanning

Objective: The complex root canal anatomy is inherently colonised by microbial flora. Endodontic treatment success is always related to adequate disinfection of the root canal space, which ultimately affects the treatment outcome. A thorough understanding of the external and internal root canal anatomy by using adequately imaging modalities is essential before planning any treatment. The aim of this study was to investigate the number and morphology of the root canals of maxillary and mandibular premolars in Chennai population. Material and Methods: Full-size cone-beam computed tomographic images were randomly collected from 100 patients, resulting in a total of 200 first and 200 second maxillary premolars as well as 200 first and 200 second mandibular premolars. All the eight premolars were analysed in single patients, who underwent cone-beam computed tomography scanning during pre-operative assessment (before implant surgery, orthodontic treatment, diagnosis of dental-alveolar trauma or difficult root canal treatment). Total number of roots and root canals, frequency and correlations between men and women were recorded and statistically analysed by using chi-square tests. The root canal configurations were rated according to the Vertucci’s classification. Results: In the maxillary first premolar group (n = 200), 36.3% had 1 root, 56.7% had 2 roots and 7.0% had 3 roots, with most exhibiting a type IV canal configuration. In the maxillary second premolar group (n = 200), 60% had 1 root, 29.8% had 2 roots and 10.2% had 3 roots, with the majority of single-rooted second premolars exhibiting a type I canal configuration. In the mandibular first premolar group (n = 200), 80.5% had 1 root, 9.8% had 2 roots and 5% had 3 roots. In the mandibular second premolar group (n=200), 90.1% had 1 root, 6.4% had 2 roots and 3.5 % had 3 roots, with most exhibiting a type I canal configuration. No statistical correlation was found between number of roots, gender and tooth position. Conclusion: This cone-beam computed tomographic study confirmed previous anatomical and morphological investigations. Therefore, the possibility of additional root canals should be considered when treating premolars. Keywords: Cone-beam computed tomography; Mandibular; Maxillary; Premolar; Root canal; Morphology.

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Endodontic Treatment of a Maxillary Central Incisor with Two Roots

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1325 ◽

2013 ◽

Vol 14 (2) ◽

pp. 345-347 ◽

Cited By ~ 1

Author(s):

Hamid Jafarzadeh ◽

Amir Maghsoudlou ◽

Maryam Forghani

Keyword(s):

Root Canal ◽

Healing Process ◽

Endodontic Treatment ◽

Clinical Report ◽

Central Incisor ◽

Root Canal Therapy ◽

Maxillary Central Incisor ◽

Root Canals ◽

Dental Anatomy ◽

Root Canal Morphology

ABSTRACT Aim This clinical report presents a rare case of maxillary central incisor with two separate roots. Background Unusual morphology of the roots and root canals may exist in any tooth. Recognition of the dental anatomy and its variations is necessary for successful endodontic therapy. It is well known that maxillary incisors are usually single-rooted teeth. Case report The root canals were instrumented with conventional hand files and Gates Glidden and obturated by using the lateral technique. Recall radiograph after 1 year shows the healing process of the preoperative apical periodontitis. Conclusion and clinical significance Clinicians should be aware of unexpected root canal morphology when performing root canal therapy. The present case demonstrated the importance of accurate preoperative radiograph and adequate access preparation. How to cite this article Maghsoudlou A, Jafarzadeh H, Forghani M. Endodontic Treatment of a Maxillary Central Incisor with Two Roots. J Contemp Dent Pract 2013;14(2):345-347.

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Micro–computed Tomographic Analysis of Mandibular Second Molars with C-shaped Root Canals

Journal of Endodontics ◽

10.1016/j.joen.2015.01.021 ◽

2015 ◽

Vol 41 (6) ◽

pp. 890-895 ◽

Cited By ~ 13

Author(s):

Pablo Andrés Amoroso-Silva ◽

Ronald Ordinola-Zapata ◽

Marco Antonio Hungaro Duarte ◽

James L. Gutmann ◽

Aldo del Carpio-Perochena ◽

...

Keyword(s):

Root Canals ◽

Computed Tomographic ◽

Tomographic Analysis

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Cone-beam computed tomography analysis on root and canal morphology of mandibular first permanent molar among multiracial population in East Coast Malaysian population

European Journal of Dentistry ◽

10.4103/ejd.ejd_82_18 ◽

2018 ◽

Vol 12 (03) ◽

pp. 410-416 ◽

Cited By ~ 1

Author(s):

Prunella Ubung Deng ◽

Mohamad Syahrizal Halim ◽

Sam'an Malik Masudi ◽

Saaid Al-Shehadat ◽

Basaruddin Ahmad

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

East Coast ◽

Cone Beam ◽

Root Canals ◽

Single Root ◽

Malaysian Population ◽

Permanent Molar ◽

Permanent Molars ◽

The Right

ABSTRACT Objective: The aim of this study is to investigate the variations in the number of root and canal in the mandibular first permanent molars (MFPMs) teeth in East Coast Malaysian population using cone-beam computed tomography (CBCT). Materials and Methods: CBCT images which show MFPMs recorded in HUSM Dental Clinic between January 2015 and June 2016 was obtained and analyzed for their number of roots and canals. A total of 208 CBCT images of MFPMs were collected; 118 patients had unilateral molars and 90 patients had bilateral molars. The following observations were made: (1) root number; (2) number of canals per root; and (3) comparisons of number of roots and canals according to gender, ethnicity, and position. Results: The majority of cases of bilateral MFPM had the same number of roots (95.6%, 95% confidence interval [CI]: 89.01%, 98.78%) on both the right and left side and only 4 cases (4.4%, 95% CI: 1.22%, 10.99%) had 3 roots on the right and 2 roots on the left sides. The majority of cases had the same number of canals on both sides (66.7%, 95% CI: 55.95, 76.26%) and 33.3% (95% CI: 23.74%, 44.05%) with unequal number of canals. The occurrence of the number of canals was not independent of the sides of the arch (P < 0.001) and there was statistically significantly greater proportion of cases who had greater number of canals on the right side than the left (P = 0.03). The prevalence of right single-rooted MFPM was very small at 0.3% (n = 1) in a Malay male (95% CI: 0.00, 1.83) and the most prevalent was two roots first molar (88.4%). The number of roots was not associated with sex or ethnic group (P > 0.05). The MFPM with a single root was found to have only one mesial canal. For two rooted MFPM, the most prevalent occurrence was two canals at the mesial and one canal at the distal roots (59%); followed by single canals in each mesial and distal (21%) and double canals per root (18%). Three roots MFPM have either single or double canals in the mesial root and double canals in the distal root. Conclusions: The majority of population in the East Coast region of Malaysia has two roots and three root canals in their MFPMs. There was no difference in the number of roots between gender and ethnic and canals between ethnic.

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Quantitative Assessment of the Edentulous Posterior Maxilla for Implant Therapy: A Retrospective Cone Beam Computed Tomographic Study

Journal of Maxillofacial and Oral Surgery ◽

10.1007/s12663-019-01236-7 ◽

2019 ◽

Vol 19 (1) ◽

pp. 125-130 ◽

Cited By ~ 1

Author(s):

Ninad Milind Padhye ◽

Neel B. Bhatavadekar

Keyword(s):

Quantitative Assessment ◽

Cone Beam ◽

Computed Tomographic ◽

Posterior Maxilla ◽

Implant Therapy

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Chemotherapy combined with radiotherapy for successful treatment of angioimmunoblastic T-cell lymphoma: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-020-02489-4 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Yudi Xiong ◽

Lei Yang ◽

Jing Dai ◽

Fuxiang Zhou ◽

Yunfeng Zhou

Keyword(s):

Radiation Therapy ◽

T Cell ◽

Cell Lymphoma ◽

T Cell Lymphoma ◽

Therapeutic Effects ◽

Case Presentation ◽

Angioimmunoblastic T Cell Lymphoma ◽

Computed Tomographic ◽

First Line Therapy ◽

Axillary Region

Abstract Background The incidence of angioimmunoblastic T-cell lymphoma is rare worldwide, and it has a poor prognosis. There is no proven or standard first-line therapy that works for the majority of patients with angioimmunoblastic T-cell lymphoma because of the rarity of this disease. The treatment and management are challenging for clinicians. Case presentation This report presents the diagnosis and treatment of a 65-year-old Chinese man who presented with cough and lymph node swellings in the left axillary region. The patient was diagnosed with angioimmunoblastic T-cell lymphoma. He underwent eight cycles of chemotherapy with CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone) followed by TOMO radiotherapy (helical tomotherapy, a kind of radiotherapy for cancer treatment using spiral computed tomographic scanning). After treatment, the therapeutic effects were evaluated by magnetic resonance imaging and computed tomography about every 3 months. The patient recovered well with no sign of tumor recurrence and no obvious severe treatment-related adverse effects. Conclusion This treatment experience indicates an essential role for the combination of radiation therapy with CHOP, which may have a better prognosis than treatments without radiation therapy. But challenges warrant further validation in prospective studies.

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