PMC9168195_01
(a, b) Preoperative view of #36 and #46. (c, d) Preoperative IOPA of #36 and #46. B: buccal; L: lingual; D: distal; M: mesial.
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Clinical examination revealed symptomatic teeth #36 and #46 with a deep carious lesion (Figures 1(a) and 1(b)). IOPA which revealed deep occlusal caries involving the buccal surface in close approximation to the pulp of the involved teeth and widening of the periodontal ligament space. IOPA also disclosed the unusual root anatomy of the mandibular first molar (Figures 1(c) and 1(d)).
Axial section of CBCT scan showing the presence of a single canal in #36 and #46 at (a) cervical third, (b) middle third, and (c) apical third.
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From CBCT analysis, it was confirmed that teeth #36 and #46 revealed a single fused root with only one canal (Figures 2 and 3).
(a-c) Coronal section of #46 at cervical, middle, and apical thirds showing the presence of a single canal. (d-f) Coronal section of #36 at cervical, middle, and apical thirds showing the presence of a single canal.
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From CBCT analysis, it was confirmed that teeth #36 and #46 revealed a single fused root with only one canal (Figures 2 and 3).
(a, b) Access openings of #36 and #46 showing the presence of a single canal.
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Further inspection of the pulpal floor under a dental operating microscope revealed a lack of any other canal orifices (Figures 4(a) and 4(b)).
(a, b) Postobturation radiograph #36 and #46. (c, d) One-year follow-up radiograph #36 and #46.
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In the next session, backfill using thermoplasticised gutta percha (Ultrafil 3D, Coltene, USA) was done (Figures 5(a) and 5(b)). Follow-up radiographs were also taken which showed good healing for both #36 and #46 and a decrease in the size of the periapical lesion for #46 (Figures 5(c) and 5(d)).