Case ReportOpen Access

3D Clinical Evaluation of Unusual Anatomy of A Maxillary Second Molar: A Case Report

Volume 2 - Issue 1

**Dario Di Nardo*¹, Gianluca Gambarini¹, Riccardo Costantini¹, Luca Testarelli¹, Lucila Piasecki² and Dina Al-Sudani³**

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- ¹Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Italy
- ²Department of Periodontics and Endodontics, University at Buffalo, USA
- ³Department of Restorative Dental Sciences, College of Dentistry, King Saud University, Saudi Arabia
*Corresponding author: Dott Dario Di Nardo, Department of Oral and Maxillo Facial Sciences, Sapienza University of Rome, Italy

Received: January 04, 2018; Published: January 10, 2018

DOI: 10.26717/BJSTR.2018.02.000648

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Abstract

Aim To present the combined use of CBCT images and new endodontic software to identify and then facilitate the location and treatment of a canal in an unusually placed second mesio-buccal root of a maxillary left second molar. Summary A 45-year-old female was referred for root canal treatment on her maxillary left second molar tooth (tooth 27). Due to superimposition of the third molar and the position of the tooth that made conventional radiographs unhelpful, a pre-operative limited FOV, Low-Dose Technology™ CBCT image was taken with an OP-300 Maxio™ device (Instrumentarium, Helsinki, Finland). The CBCT images were then imported and analyzed using 3D Endo™ Software (Dentsply Sirona, Wels bei Salzburg, Austria). Within the software, the canal orifices and foramina were located and identified on the display, which allowed the software to automatically reveal and measure the pathway of each canal, which was traced and viewed in both frontal and mesial perspectives. The images revealed the presence of a separate second mesiobuccal root that contained one canal. Root canal treatment was then performed using the information derived from the software. The orifice of the canal in the second MB root was located in an unusual position: 5.99 mm palatally to the main MB canal and 7.57 mm medially from the palatal canal. An immediate post-operative limited FOV, low-dose CBCT was taken to assess the quality of the root filling. After one year the tooth was asymptomatic and radiographic examination revealed no sign of periapical pathosis.

Keywords: Anatomy, Maxillary Molar, Mesio-Buccal Canal, CBCT

Key Learning Points:

a) The variable anatomy of maxillary second molar teeth

b) The unusual (palatal) location of the second mesio-buccal root and canal in this case

c) The combined use of CBCT and 3D endodontic software for pre-operative assessment of complex cases in order to identify and manage risk.