Mishra Anisha, Natanasabapathy Velmurugan, Kowsky Dinesh, Sharan Jitendra, Marya Anand
Department of Dentistry All India Institute of Medical Sciences Bhubaneswar India.
Department of Conservative Dentistry and Endodontics, Faculty of Dentistry Meenakshi Ammal Dental College & Hospital, Meenakshi Academy of Higher Education and Research (MAHER) Chennai India.
Clin Case Rep. 2023 May 5;11(5):e7312. doi: 10.1002/ccr3.7312. eCollection 2023 May.
Clinicians should be aware of the variations in the number of roots and root canals and the peculiar or eccentric location of root canals. An intraoperative CBCT can be very useful in improved visualization of the anatomical variations.
This case report describes the unusual location of the distobuccal root canal in a maxillary second molar with root fusion. On access opening, three distinct root canal orifices, the mesiobuccal canal, palatal canal, and a third orifice closer to the palatal canal, were seen, giving an illusion of an additional palatal canal. An attempt was made to search for the distobuccal canal in its usual position, leading to the gouging of the pulp chamber floor. An intraoperative limited field of view cone-beam computed tomography (CBCT) revealed the root orifice adjacent to the palatal canal was the distobuccal canal. CBCT also revealed fusion of both the buccal and palatal roots in the root's coronal and middle third region, but they were not fused apically.
临床医生应了解牙根和根管数量的变化以及根管的特殊或偏心位置。术中CBCT对于更好地观察解剖变异非常有用。
本病例报告描述了一例上颌第二磨牙牙根融合时远颊根管的异常位置。在开髓时,可见三个明显的根管口,即近颊根管、腭根管以及靠近腭根管的第三个根管口,给人一种额外腭根管的错觉。试图在其通常位置寻找远颊根管,导致髓室底被凿穿。术中有限视野锥形束计算机断层扫描(CBCT)显示,靠近腭根管的根管口是远颊根管。CBCT还显示颊根和腭根在牙根冠部和中部三分之一区域融合,但根尖未融合。