Manik Khyati, Ikhar Anuja, Patel Aditya, Chandak Manoj, Bhopatkar Jay, Bhojwani Priyanka R, Rathod Pratik
Department of Conservative Dentistry and Endodontics, Sharad Pawar Dental College and Hospital, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 May 28;16(5):e61266. doi: 10.7759/cureus.61266. eCollection 2024 May.
Dental anatomy exhibits considerable variation with the presence of additional canals being a common occurrence. The upper second molar typically presents with three canals and three roots; however, variations such as the existence of an extra canal or a root can pose challenges during endodontic treatment. Maxillary molar is characterized by an additional canal located within the palatal root, often exhibiting complex configurations and variations in morphology. Access refinement is critical to gaining adequate visibility and facilitating instrumentation. Meticulous exploration of the pulp chamber floor and careful examination of radiographs from different angles are essential for accurate diagnosis. Careful negotiation and cleaning of the extra canal with appropriate files and irrigants are essential to remove pulp tissue and debris effectively. Furthermore, obturation of the canal space with biocompatible materials is crucial to ensure a three-dimensional seal and prevent bacterial ingress. Clinically, the inability to detect and treat the extra palatal canal can lead to persistent infection, incomplete debridement, and compromised treatment outcomes. This case report delves into the significance of this anatomical variation, diagnostic modalities, and effective management strategies.
牙体解剖结构存在相当大的变异，额外根管的存在很常见。上颌第二磨牙通常有三个根管和三个牙根；然而，诸如额外根管或牙根的存在等变异在牙髓治疗过程中可能带来挑战。上颌磨牙的特征是在腭根内有一个额外的根管，其形态往往复杂且存在变异。精修髓腔入口对于获得足够的视野和便于器械操作至关重要。仔细探查髓室底并从不同角度仔细查看X光片对于准确诊断必不可少。使用合适的锉和冲洗剂仔细疏通和清理额外根管对于有效清除牙髓组织和碎屑至关重要。此外，用生物相容性材料充填根管空间对于确保三维密封和防止细菌侵入至关重要。临床上，无法检测和处理额外的腭侧根管可导致持续性感染、清创不彻底以及治疗效果受损。本病例报告深入探讨了这种解剖变异的意义、诊断方法和有效的管理策略。
