Riyahi Abdullah Mahmoud
Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia.
Case Rep Dent. 2019 Dec 23;2019:8403140. doi: 10.1155/2019/8403140. eCollection 2019.
Three rooted lower first permanent molar represents one of the main anatomical variants which is a treatment challenge of clinicians. This study is aimed at presenting a case of a lower first molar with an additional root that was diagnosed and managed successfully using new techniques in endodontics. Tooth #46 was diagnosed as a necrotic pulp with symptomatic apical periodontitis. Different angle radiographs were obtained, and they clearly showed three roots. The procedure was completed under magnification and illumination using an operating microscope. The access cavity was modified to achieve straight line access for all the canals. Careful step-by-step instrumentation was performed using flexible NiTi rotary files. The canals were irrigated using 6% sodium hypochlorite. Afterwards, three-dimensional obturation was completed using warm vertical compaction. Knowledge of the anatomy and an early diagnosis are required to achieve high-quality root canal treatment.
三根下颌第一恒磨牙是主要的解剖变异之一，对临床医生来说是一个治疗挑战。本研究旨在介绍一例下颌第一磨牙额外多一根的病例，该病例采用牙髓病学新技术成功诊断并进行了治疗。46号牙被诊断为牙髓坏死伴症状性根尖周炎。拍摄了不同角度的X线片，清晰显示有三根牙根。手术在手术显微镜的放大和照明下完成。对开髓洞形进行修改，以实现所有根管的直线通路。使用柔性镍钛旋转锉进行仔细的逐步根管预备。根管使用6%次氯酸钠冲洗。之后，采用热垂直加压法完成三维根管充填。要实现高质量的根管治疗，需要了解解剖结构并进行早期诊断。
