Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jun 26, 2020; 8(12): 2590-2596
Published online Jun 26, 2020. doi: 10.12998/wjcc.v8.i12.2590
Endodontic management of the maxillary first molar with special root canals: A case report and review of the literature
Zhi-Hui Zhang, Hai-Lin Yao, Yan Zhang, Xiao Wang
Zhi-Hui Zhang, Hai-Lin Yao, Xiao Wang, Stomatology Department, Peking University Third Hospital, Beijing 100191, China
Yan Zhang, Department of Stomatology, Peking University Third Hospital Yanqing Hospital, Beijing 102100, China
Author contributions: Zhang ZH designed the plan, treated the patient, and wrote the paper; Yao HL and Zhang Y collected the material and clinical data; Wang X modified the paper.
Supported by the National Natural Science Foundation of China, No. 81800983; and Beijing Natural Science Foundation, No. 7164310.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Zhi-Hui Zhang, PhD, Attending Doctor, Stomatology Department , Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing 100191, China. wisdomzhangzhihui@163.com
Received: March 8, 2020
Peer-review started: March 8, 2020
First decision: April 21, 2020
Revised: May 2, 2020
Accepted: May 26, 2020
Article in press: May 26, 2020
Published online: June 26, 2020
Abstract
BACKGROUND

As the complex anatomy of maxillary first molars is one of the major challenges in endodontic therapy, knowledge of the complicated root canal anatomy and configuration is crucial to ensure the success of endodontic treatment and prognosis. This article presents an endodontically managed left maxillary first molar with an unusual palatal root morphology. The available literature on the anatomic variation of maxillary first molars is also reviewed.

CASE SUMMARY

A 36-year-old man with no medical history presented to the Stomatology Department of Peking University Third Hospital complaining of a toothache during mastication in the maxillary left posterior region for approximately 3 mo. He had a spontaneous and intermittent toothache that had worsened, particularly at night. The diagnosis based on clinical examination, X-ray imaging, and cone beam computed tomography (CBCT) was symptomatic irreversible pulpitis. Nonsurgical endodontic therapy was performed for the left maxillary first molar. Five root canals revealed by CBCT included a special palatal root canal (1-2-1-shaped), two mesiobuccal root canals, and one distobuccal root canal. Evaluation of the CBCT images confirmed the root canal morphology and the clinician performed more effective cleaning, obturation, and therapy. Finally, the tooth was restored using composite resin, and the patient was satisfied with the result.

CONCLUSION

CBCT and a complete review of the literature may be beneficial for investigating the root canal system to achieve a biological and functional therapeutic effect.

Keywords: Maxillary first molar, Root canal anatomy, Morphology, Endodontic treatment, Cone beam computed tomography, Case report

Core tip: A rare case of the left maxillary first molar with a special palatal root canal (1-2-1-shaped) is described in detail. The range of knowledge on the anatomy of root canals in the permanent maxillary first molar is extended. Cone beam computed tomography is an effective means for understanding complicated root canal anatomy and plays a significant role in the diagnosis and treatment of endodontic diseases.