Journal of Dentistry of Tehran University of Medical Sciences 2017. 14(2):100-104.

Treatment of a Four-Rooted Maxillary Second Molar Detected with Cone-Beam Computed Tomography
Nahid Mohammadzade Akhlaghi, Mahta Fazlyab


The significance of clinician’s knowledge about root canal anatomy and its possible variations cannot be overlooked. In some cases, taking advantage of complementary imaging techniques can help achieve a perfect flawless endodontic treatment. This article reports endodontic management of a second maxillary molar that had an uncommon anatomy of the chamber floor. After obtaining a cone-beam computed tomography (CBCT) image, the presence of a second palatal root was confirmed. All four roots were treated and patient’s symptoms were resolved.

Keywords: Cone-Beam Computed Tomography; Root Canal Therapy; Tooth Root


Cone-Beam Computed Tomography; Root Canal Therapy; Tooth Root

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- Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endod topics. 2005 Mar;10(1):3-29.

- Pecora JD, Woelfel JB, Sousa Neto MD. Morphologic study of the maxillary molars. 1. External anatomy. Braz Dent J. 1991;2(1):45-50.

- Ross IF, Evanchik PA. Root fusion in molars: incidence and sex linkage. J Periodontol. 1981 Nov;52(11):663-7.

- al Shalabi RM, Omer OE, Glennon J, Jennings M, Claffey NM. Root canal anatomy of maxillary first and second permanent molars. Int Endod J. 2000 Sep;33(5):405-14.

- Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod. 2004 Jun;30(6):391-8.

- Pawar AM, Kokate SR. Contemporary endodontic management of four rooted maxillary second molar using waveOne. Contemp Clin Dent. 2014 Jan;5(1): 130-3.

- Paul B, Dube K. Endodontic treatment of a maxillary second molar with two separate palatal roots: a case report. J Clin Diagn Res. 2013 Dec;7(12):3127.

- Patel S, Patel P. Endodontic management of maxillary second molar with two palatal roots: a report of two cases. Case Rep Dent. 2012; 2012:590406.

- Fahid A, Taintor JF. Maxillary second molar with three buccal roots. J Endod. 1988 Apr;14(4):181-3.

- Brito M, Jr., Moreira G, Jr., Normanha JA, Faria-e-Silva AL, Camilo CC, Savioli RN, et al. Midbuccal canals of maxillary molars evaluated by cone-beam computed tomography: endodontic management of two cases. Braz Dent J 2013 Dec;24(6):575-9.

- Zmener O, Peirano A. Endodontic therapy in a maxillary second molar with three buccal roots. J Endod. 1998 May;24(5):376-7.

- Jafarzadeh H, Javidi M, Zarei M. Endodontic retreatment of a maxillary second molar with three separate buccal roots. Aust Endod J. 2006 Dec; 32(3):129-32.

- Kottoor J, Hemamalathi S, Sudha R, Velmurugan N. Maxillary second molar with 5 roots and 5 canals evaluated using cone beam computerized tomography: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Feb;109(2):e162-5.

- Simsek N, Keles A, Bulut ET. Unusual root canal morphology of the maxillary second molar: a case report. Case Rep Dent. 2013;2013:138239.

- Ashraf H, Dianat O, Hajrezai R, Paymanpour P, Azadnia S. Endodontic treatment of a double-rooted maxillary second molar with four canals: a case report. Iran Endod J. 2014 Fall;9(4):304-6.

- Christie WH, Peikoff MD, Fogel HM. Maxillary molars with two palatal roots: a retrospective clinical study. J Endod. 1991 Feb;17(2):80-4.

- Bjørndal L, Carlsen O, Thuesen G, Darvann T, Kreiborg S. External and internal macromorphology in 3D‐reconstructed maxillary molars using computerized X‐ray microtomography. Int Endod J. 1999 Jan;32(1):3-9.

- Kiarudi AH, Eghbal MJ, Safi Y, Aghdasi MM, Fazlyab M. The applications of cone-beam computed tomography in endodontics: a review of literature. Iran Endod J. 2015 Winter;10(1):16-25.

- Patel S, Durack C, Abella F, Shemesh H, Roig M, Lemberg K. Cone beam computed tomography in Endodontics - a review. Int Endod J. 2015 Jan;48(1):3-15.

- Tamse A, Kaffe I, Fishel D. Zygomatic arch interference with correct radiographic diagnosis in maxillary molar endodontics. Oral Surg Oral Med Oral Pathol. 1980 Dec;50(6):563-6.

- Silva EJ, Nejaim Y, Silva AI, Haiter-Neto F, Zaia AA, Cohenca N. Evaluation of root canal configuration of maxillary molars in a Brazilian population using cone-beam computed tomographic imaging: an in vivo study. J Endod. 2014 Feb;40(2): 173-6.

- Pineda F, Kuttler Y. Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals. Oral Surg Oral Med Oral Pathol. 1972 Jan;33(1):101-10.

- Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol. 1984 Nov;58(5):589-99.

- Libfeld H, Rotstein I. Incidence of four-rooted maxillary second molars: literature review and radiographic survey of 1,200 teeth. J Endod. 1989 Mar;15(3):129-31.

- Fakhari E, Shokraneh A. A maxillary second molar with two separate palatal roots: a case report.J Dent (Shiraz). 2013 Jun;14(2):87-9.

- Rouhani A, Bagherpour A, Akbari M, Azizi M, Nejat A, Naghavi N. Cone-beam computed tomography evaluation of maxillary first and second molars in Iranian population: a morphological study. Iran Endod J. 2014 Summer;9(3):190-4.

- Ghoddusi J, Mesgarani A, Gharagozloo S. Endodontic re-treatment of maxillary second molar with two separate palatal roots: a case report. Iran Endod J. 2008 Summer;3(3):83-5.

- Shojaeian S, Ghoddusi J, Hajian S. A case report of maxillary second molar with two palatal root canals and a furcal enamel pearl. Iran Endod J. 2013 Winter;8(1):37-9.

- Eskandarinezhad M, Ghasemi N. Nonsurgical endodontic retreatment of maxillary second molar with two palatal root canals: a case report. J Dent Res Dent Clin Dent Prospects. 2012 Aug;6(2):75-8.


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