Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2022; 10(32): 12036-12044
Published online Nov 16, 2022. doi: 10.12998/wjcc.v10.i32.12036
Endodontic treatment of the maxillary first molar with palatal canal variations: A case report and review of literature
Kai Chen, Xing Ran, Yan Wang
Kai Chen, Department of Stomatology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
Xing Ran, Department of Stomatology, Shanghai Jiading District Center for Dental Disease Prevention and Control, Shanghai 201899, China
Yan Wang, Department of Stomatology, Eye and Dental Diseases Prevention & Treatment of Pudong New Area, Shanghai 201399, China
Author contributions: Chen K performed the treatment, collected data, and wrote the manuscript; Ran X contributed to data collection; Wang Y conceived the study, provided financial support, and reviewed the manuscript; and all authors read and approved the manuscript.
Supported by The Health Discipline Construction Project in Pudong New Area, No. PWYts2021-20.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Yan Wang, MM, Doctor, Department of Stomatology, Eye and Dental Diseases Prevention & Treatment of Pudong New Area, No. 222 Wenhua Road, Pudong New Area, Shanghai 201399, China. 58180243@qq.com
Received: August 16, 2022
Peer-review started: August 16, 2022
First decision: September 5, 2022
Revised: September 17, 2022
Accepted: October 13, 2022
Article in press: October 13, 2022
Published online: November 16, 2022
Abstract
BACKGROUND

Root canal variations frequently occur in maxillary first molars, which greatly affects the success of its treatment. The second mesiobuccal (MB) root canal is the most common root canal variation. However, only a few studies have been conducted on palatal root canal variations. Herein, we report the presence of two separate root canals in a palatal root of the maxillary first molar.

CASE SUMMARY

A 39-year-old woman complained of pain in the maxillary right region for 1 year, which recently worsened. Clinical examination revealed a poorly restored right maxillary first molar and caries detected at the filling marginal. Cold and heat test results indicated severe pain in the right maxillary first molar. The patient was diagnosed with irreversible pulpitis, and subsequently, root canal treatment (RCT) was performed. In total, five root canals were found in the maxillary first molar, including two separate root canals in the palatal root. RCT was successfully performed using an endodontic microscope and cone-beam computed tomography (CBCT). The CBCT image revealed a vertucci type I canal morphology in the distobuccal root, while the MB and palatal root canals were type Ⅳ. At the 1-mo follow-up, the maxillary first molar was completely asymptomatic, and the X-ray results indicated a successful RCT. Finally, the ceramic crown restoration was performed.

CONCLUSION

An endodontic microscope and CBCT are useful in effectively identifying and treating root canal variations.

Keywords: Molar, Root canal, Endodontics, Dental pulp cavity, Pulpitis, Case report

Core Tip: This report presents a case of non-surgical root canal treatment of the right maxillary first molar. Five root canals were identified in the maxillary first molar, including two separate root canals in the palatal root. Endodontic microscope and cone-beam computed tomography were helpful in the localization and treatment of complex canal variations.