Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 6, 2019; 7(1): 79-88
Published online Jan 6, 2019. doi: 10.12998/wjcc.v7.i1.79
Endodontic management of the maxillary first molars with two root canals: A case report and review of the literature
Jie Liu, Ke-Hua Que, Zuo-Hui Xiao, Wen Wen
Jie Liu, Ke-Hua Que, Wen Wen, Department of Endodontics, College of Stomatology, Tianjin Medical University, Tianjin 300070, China
Zuo-Hui Xiao, Department of Geriatric Dentistry, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing 100081, China
Zuo-Hui Xiao, Laboratory of Biomedical Materials, Peking University School and Hospital of Stomatology, Beijing 100081, China
Wen Wen, Department of Stomatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin 300120, China
Author contributions: Que KH and Wen W designed the treatment plan for patients; Liu J and Wen W treated patients; Liu J, Wen W and Xiao ZH collected material and clinical data; Liu J wrote the paper.
Informed consent statement: Consent was obtained from the patients for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Wen Wen, DDS, Doctor, Department of Endodontics, College of Stomatology, Tianjin Medical University, Heping District, Qixiangtai Road, No. 12, Tianjin 300070, China. tjdentwen92@163.com
Telephone: +86-22-23332095
Received: November 1, 2018
Peer-review started: November 1, 2018
First decision: November 16, 2018
Revised: November 26, 2018
Accepted: November 30, 2018
Article in press: December 1, 2018
Published online: January 6, 2019
Processing time: 64 Days and 17.9 Hours
Abstract
BACKGROUND

The complex anatomy of the maxillary first molars has always been a major challenge for complete root canal treatment in endodontic therapy. Here, we present two cases of maxillary first molars, each with only two root canals, which have been rarely reported. We also perform a literature review of maxillary first molar anatomy.

CASE SUMMARY

The two patients were referred to the hospital after 1) finding a cavity in their tooth with a color change and, 2) a toothache during mastication, respectively. Both of these cases were diagnosed as apical periodontitis by X-ray imaging and cone beam computed tomography (CBCT). Non-surgical endodontic therapy was performed with the assistance of a dental operating microscope (DOM). CBCT showed rare but accurate images of both patients, each with two root canals and two roots in their maxillary first molars. Both roots were located in the buccal in the palatal direction, and each root had only one clear root canal. In addition, each maxillary first molar in both patients was symmetrical to that on the opposing side with only two separate root canals. Non-surgical endodontic therapy was performed with the assistance of a DOM. Finally, the teeth were restored using composite resin and the patients were satisfied with the results.

CONCLUSION

Making full use of CBCT and DOM would contribute to helping dentists make correct diagnoses and successfully treat teeth with rare root canal morphologies.

Keywords: Root canal anatomy; Maxillary first molar; Cone beam computed tomography; Dental operating microscope; Endodontic therapy; Case report

Core tip: We describe two rare cases of maxillary first molars with only two separate root canals. An additional impressive finding was that the left and right sides were symmetrical, which extend the range of knowledge on both roots and root canals in relation to permanent maxillary first molar anatomy. Advanced surgical facilities and diagnostic methods, such as cone beam computed tomography and dental operating microscopy, play an important role in the diagnosis and treatment of these endodontic diseases and facilitate a better understanding of complicated root canal treatment.