Bertrand Thikamphaa, Kim Sahng Gyoon
Division of Endodontics, Columbia University College of Dental Medicine, New York, NY, USA.
Restor Dent Endod. 2016 Feb;41(1):68-73. doi: 10.5395/rde.2016.41.1.68. Epub 2016 Jan 19.
This case report describes a unique C-shaped mandibular second premolar with four canals and three apical foramina and its endodontic management with the aid of cone-beam computer tomography (CBCT). C-shaped root canal morphology with four canals was identified under a dental operating microscope. A CBCT scan was taken to evaluate the aberrant root canal anatomy and devise a better instrumentation strategy based on the anatomy. All canals were instrumented to have a 0.05 taper using 1.0 mm step-back filing with appropriate apical sizes determined from the CBCT scan images and filled using a warm vertical compaction technique. A C-shaped mandibular second premolar with multiple canals is an anatomically rare case for clinicians, yet its endodontic treatment may require a careful instrumentation strategy due to the difficulty in disinfecting the canals in the thin root area without compromising the root structure.
本病例报告描述了一例独特的C形下颌第二前磨牙，其有四条根管和三个根尖孔，并借助锥形束计算机断层扫描（CBCT）对其进行根管治疗。在牙科手术显微镜下识别出具有四条根管的C形根管形态。进行CBCT扫描以评估异常的根管解剖结构，并根据解剖结构制定更好的根管预备策略。使用1.0 mm逐步后退法将所有根管预备至0.05锥度，根据CBCT扫描图像确定合适的根尖尺寸，并采用热垂直加压技术进行充填。对于临床医生来说，具有多条根管的C形下颌第二前磨牙在解剖学上是罕见的病例，然而由于在不破坏牙根结构的情况下对细根区域的根管进行消毒存在困难，其根管治疗可能需要谨慎的根管预备策略。
