Faculty, Staff and Student Publications

Publication Date

1-1-2024

Journal

Frontiers in Dental Medicine

Abstract

It is difficult to predict the outcomes of non-surgical root canal treatment (NSRCT) for mandibular second premolars with multiple root canals. In these teeth, the complicated anatomy with fin(s), or a C-shape, and possible secondary canal(s) varies unpredictably. The morphology of the root canals provides shelters for bacteria to remain, regrow, and form biofilms despite the endodontic treatment. Moreover, the prevalence of mandibular second premolars with multiple canals is extremely infrequent. Therefore, the clinical management of NSRCT in such cases is not sufficiently reported. This case report introduces two cases of NSRCT for mandibular second premolars with a radicular groove and also presents the appropriate clinical strategies and techniques. Cone-beam computed tomography (CBCT) imaging was used preoperatively. After the completion of NSRCT, CBCT was reused to review the completed procedures using the Nerve Canal tool in CS 3D Imaging v3.2.9 and v3.8.7. Five canals were obturated in case 1, and four canals in case 2 along with a C-shape morphology. Analyzing the configuration of the root canals by CBCT was critical to achieve successful NSRCT because the numbers, exits, configurations, and volumes of the secondary canals were not anticipated after reviewing 2D radiographs. Based on the interpretation, the advanced protocols of NSRCT were planned: first, augmentation of chemo-mechanical cleaning, but minimizing the loss of dentine; second, the tactile examination to locate and negotiate the orifices of the secondary canals; and lastly, the optimized plan and technique for root canal filling of the complex canal systems.

Keywords

CBCT, C-shape, mandibular second premolar, non-surgical root canal treatment, radicular groove, root canal anatomy

DOI

10.3389/fdmed.2024.1403138

PMID

39917669

PMCID

PMC11797813

PubMedCentral® Posted Date

5-9-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Included in

Dentistry Commons

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