Endodontic Management of Four-Rooted Maxillary Second Molar using A Novel Single-File Rotary System : ACase Report

Abstract

(5) four roots . The following case report describes a Minimally Invasive Endodontic management of rare case of maxillary second molar with two buccal and two independent palatal roots using TruNatomy File Rotary System(DentsplySirona). Case Report A 38 year old man reported to Department of Conservative Dentistry and Endodontics complaining of pain in maxillary right back area since 2 weeks. The patient did not present with any relevant medical history. Clinical examination revealed deep disto-occlusal caries in maxillary second molar number 17. Radiographic examination showed disto-occlusal coronal radiolucency approaching pulp. Vitality test was performed and diagnosis of symptomatic irreversible pulpitis was made. Root canal therapy was advised and informed consent was obtained. The tooth was anesthetized, isolated and access cavity was prepared. Three canal orifices were located – Mesiobuccal, Distobuccal and Palatal. Canal patency was checked with No.8 K file. However, after inserting the file in the palatal canal, it was observed that the file had tilted mesially. It hinted a different canal anatomy. Upon closer examination of the dentinal map under magnification, the access cavity was extended mesially and an extra palatal canal was found located mesial to the initially found palatal canal, which was confirmed radiographically. Working length was established using Electronic Apex Locator [Raypex 6 (VDW, Munich, Germany)] and the root canal instrumentation was completed using TruNatomy File Rotary System. Obturation was completed using lateral condensation technique. The patient was recalled at 1,3,6 and 12 months period and follow up radiographs were taken. The tooth was asymptomatic.