PMC5683840_01
a) Preoperative radiograph; b) The limited volume CBCT axial scan at coronal third; c) The limited volume CBCT axial scan at middle third; d) The limited volume CBCT axial scan at apical third; e) The limited volume CBCT sagittal scan confirming Vertucci type IV canal configuration. f) Access cavity preparation under DOM 8x; g) Working length radiograph; h) Radiograph with master guttapercha in place; l) Immediate post obturation radiograph; j) Follow up radiograph after three months; k) Follow up radiograph after six months.
cm-90-459f1b.jpg
PMC5683840_01_cm-90-459f1b.jpg
f1-cm-90-459
Conventional intraoral periapical radiograph failed to provide adequate information regarding the canal configuration and all the roots looked fused and their outline were not clear (Figure 1a). After careful evaluation of axial sections at coronal, middle and apical third and sagittal section, it was confirmed that MB root had an additional MB2 canal which was separated throughout the length from MB1 and exited as two separate apical foramina, thus confirming the Vertucci type IV root canal configuration (Figures 1 b,c.d,e). Louis MO, USA) 8x, all the three root canal orifices were visible at the floor but the orifice for MB1 was hidden under the thin shelves of the dentin (Figure 1f). Morita, Kyoto, Japan) apex locator for all the four root canals and confirmed by a radiograph (Figure 1g). Selected master GP were placed in all the canals and a check radiograph was taken to evaluate the fit (Figure 1h). Immediate post obturation radiograph showed well obturated root canals (Figure 1 i). The patient was asymptomatic during follow-up after 3 months (Figure 1j) and six months (Figure 1k) and was advised to get the final post endodontic restoration done for the tooth.