Limits...
Identification and Endodontic Management of Middle Mesial Canal in Mandibular Second Molar Using Cone Beam Computed Tomography.

Paul B, Dube K - Case Rep Dent (2015)

Bottom Line: Endodontic treatments are routinely done with the help of radiographs.Failure to identify aberrant anatomy can lead to endodontic failure.This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative Dentistry and Endodontics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh 482005, India.

ABSTRACT
Endodontic treatments are routinely done with the help of radiographs. However, radiographs represent only a two-dimensional image of an object. Failure to identify aberrant anatomy can lead to endodontic failure. This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals.

No MeSH data available.


CBCT.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4664793&req=5

fig3: CBCT.

Mentions: A 45-year-old patient with a noncontributory medical history reported to the Department of Conservative Dentistry and Endodontics, Hitkarini Dental College and Hospital, Jabalpur, with pain in his mandibular right second molar. Clinical examination revealed a deep carious lesion and the tooth was tender to percussion. There was absence of sinus tract. Vitality testing with a dry ice (R C ice Prime Dental) gave no response. A diagnosis of pulp necrosis with acute apical periodontitis was made and it was decided to go ahead with the endodontic treatment of the same tooth after informing the patient. After 2% lidocaine was administered the concerned area was isolated with a rubber dam (Hygenic, Coltene Whaledent). A conventional access cavity was prepared after excavation of caries. Clinical examination with a DG 16 (Hu-Freidy, USA) explorer revealed three mesial orifices and one distal canal (Figure 1). The canal lengths were measured using apex locator (ROOT ZX, MORITA). A radiograph was taken to confirm the working length and the presence of three mesial canals (mesiobuccal, mesiolingual, and middle mesial) and one distal canal (Figure 2). Three separate mesial orifices were verified using CBCT of the same tooth (Figure 3). The middle mesial canal joined apically with the mesiolingual canal. The canal orifices were widened using Gates Glidden drills (MANI) and apical preparation up to 30 no (2%) was carried out in the mesial canals and up to 35 no (2%) in the distal canal using K-Flexofiles (Dentsply Maillefer) and EDTA (Maillefer Dentsply, USA) as lubricant. Irrigation was carried using normal saline and 3% sodium hypochlorite (Vishal Dental products, India). After drying the canals with paper points (Dentsply, India), master cones (Dentsply, India) were selected which were confirmed by radiographs (Figure 4). The canals were obturated using AH Plus (DeTrey/Dentsply, Germany) as sealer by lateral condensation technique. A temporary dressing (Cavit G,3M ESPE, Germany) was given and a radiograph was taken to confirm the obturation (Figure 5). The patient was recalled after a week and was found to be asymptomatic. A full coverage crown was later on placed after a permanent restoration. The patient has been followed up for two years and is asymptomatic (Figure 6).


Identification and Endodontic Management of Middle Mesial Canal in Mandibular Second Molar Using Cone Beam Computed Tomography.

Paul B, Dube K - Case Rep Dent (2015)

CBCT.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664793&req=5

fig3: CBCT.
Mentions: A 45-year-old patient with a noncontributory medical history reported to the Department of Conservative Dentistry and Endodontics, Hitkarini Dental College and Hospital, Jabalpur, with pain in his mandibular right second molar. Clinical examination revealed a deep carious lesion and the tooth was tender to percussion. There was absence of sinus tract. Vitality testing with a dry ice (R C ice Prime Dental) gave no response. A diagnosis of pulp necrosis with acute apical periodontitis was made and it was decided to go ahead with the endodontic treatment of the same tooth after informing the patient. After 2% lidocaine was administered the concerned area was isolated with a rubber dam (Hygenic, Coltene Whaledent). A conventional access cavity was prepared after excavation of caries. Clinical examination with a DG 16 (Hu-Freidy, USA) explorer revealed three mesial orifices and one distal canal (Figure 1). The canal lengths were measured using apex locator (ROOT ZX, MORITA). A radiograph was taken to confirm the working length and the presence of three mesial canals (mesiobuccal, mesiolingual, and middle mesial) and one distal canal (Figure 2). Three separate mesial orifices were verified using CBCT of the same tooth (Figure 3). The middle mesial canal joined apically with the mesiolingual canal. The canal orifices were widened using Gates Glidden drills (MANI) and apical preparation up to 30 no (2%) was carried out in the mesial canals and up to 35 no (2%) in the distal canal using K-Flexofiles (Dentsply Maillefer) and EDTA (Maillefer Dentsply, USA) as lubricant. Irrigation was carried using normal saline and 3% sodium hypochlorite (Vishal Dental products, India). After drying the canals with paper points (Dentsply, India), master cones (Dentsply, India) were selected which were confirmed by radiographs (Figure 4). The canals were obturated using AH Plus (DeTrey/Dentsply, Germany) as sealer by lateral condensation technique. A temporary dressing (Cavit G,3M ESPE, Germany) was given and a radiograph was taken to confirm the obturation (Figure 5). The patient was recalled after a week and was found to be asymptomatic. A full coverage crown was later on placed after a permanent restoration. The patient has been followed up for two years and is asymptomatic (Figure 6).

Bottom Line: Endodontic treatments are routinely done with the help of radiographs.Failure to identify aberrant anatomy can lead to endodontic failure.This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals.

View Article: PubMed Central - PubMed

Affiliation: Department of Conservative Dentistry and Endodontics, Hitkarini Dental College and Hospital, Jabalpur, Madhya Pradesh 482005, India.

ABSTRACT
Endodontic treatments are routinely done with the help of radiographs. However, radiographs represent only a two-dimensional image of an object. Failure to identify aberrant anatomy can lead to endodontic failure. This case report presents the use of three-dimensional imaging with cone beam computed tomography (CBCT) as an adjunct to digital radiography in identification and management of mandibular second molar with three mesial canals.

No MeSH data available.