Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2022; 10(14): 4632-4639
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4632
Successful individualized endodontic treatment of severely curved root canals in a mandibular second molar: A case report
Lai-Jun Xu, Jian-Ying Zhang, Zi-Hua Huang, Xiang-Zhu Wang
Lai-Jun Xu, Jian-Ying Zhang, Zi-Hua Huang, Xiang-Zhu Wang, Hunan Key Laboratory of Oral Health Research; Hunan 3D Printing Engineering Research Center of Oral Care; Hunan Clinical Research Center of Oral Major Diseases and Oral Health; Academician Workstation for Oral-maxilofacial and Regenerative Medicine and Xiangya Stomatological Hospital; Xiangya School of Stomatology, Central South University, Changsha 410008, Hunan Province, China
Author contributions: Xu LJ contributed to conceptualization, original draft preparation, manuscript editing, and software; Zhang JY contributed to data curation, manuscript editing, methodology, and advice; Huang ZH was involved in visualization and investigation; Wang XZ was responsible for supervision, methodology, validation, and manuscript writing, reviewing, and editing; all authors read and approved the final manuscript.
Supported by Natural Science Foundation of Hunan Province, No. S2021JJQNJJ1682; and Changsha Municipal Natural Science Foundation, No. kq 2014215.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and the images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiang-Zhu Wang, Doctor, Department of Operative Dentistry and Endodontics, Xiangya Stomatological Hospital, Central South University, No. 72 Xiangya Road, Kaifu District, Changsha 410083, Hunan Province, China. wangxiangzhu_endo@csu.edu.cn
Received: November 6, 2021
Peer-review started: November 6, 2021
First decision: December 27, 2021
Revised: December 28, 2021
Accepted: March 6, 2022
Article in press: March 6, 2022
Published online: May 16, 2022
Abstract
BACKGROUND

The incidence rate of severely curved root canals in mandibular molars is low, and the root canal treatment of mandibular molars with this aberrant canal anatomy may be technically challenging.

CASE SUMMARY

A 26-year-old Chinese female patient presented with intermittent and occlusal pain in the left mandibular second molar. The patient had undergone filling restoration for caries before endodontic consultation. With the aid of cone beam computed tomography (CBCT), a large periapical radiolucency was observed, and curved root canals in a mandibular second molar were confirmed, depicting a severe and curved distolingual root. Nonsurgical treatments, including novel individualized preparation skills and techniques and the use of bioceramic materials as an apical barrier, were performed, and complete healing of the periapical lesion and a satisfactory effect were achieved.

CONCLUSION

A case of severely curved root canals in a mandibular second molar was successfully treated and are reported herein. The complex anatomy of the tooth and the postoperative effect were also evaluated via the three-dimensional reconstruction of CBCT images, which accurately identified the aberrant canal morphology. New devices and biomaterial applications combined with novel synthesis techniques can increase the success rate of intractable endodontic treatment.

Keywords: Cone beam computed tomography, Canal curvature, Mandibular second molar, Root canal therapy, Case report

Core Tip: The treatment of patients with severely curved root canals is problematic. Herein, with the guidance of cone beam computed tomography, individualized preparation skills and techniques and the use of bioceramic materials as an apical barrier may aid in the treatment of such severely curved teeth.