PMC3399371_01
Preoperative radiograph with different angulations: complex root anatomy of maxillary right second molar.
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fig1
Careful examination of the radiographs revealed the possibility of more than 1 palatal root (Figures 1(a) and 1(b)).
Clinical and radiographic tracing of sinus.
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fig2
Tracing of the sinus tract was done by gutta-percha (Dentsply Maillefer, Ballaigues, Switzerland) (Figures 2(a) and 2(b)).
Clinical examination showing 4 root canal orifices: 2 located buccally and 2 palatally (mirror image).
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fig3
Clinical evaluation of chamber floor confirmed the presence of 4 root canal orifices, 2 located buccally and 2 palatally (Figure 3).
Working length radiograph of different canals.
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fig4
Tokyo, Japan) and confirmed with digital intraoral periapical (IOPA) radiography (Figures 4(a) and 4(b)). The root canals were cleaned and shaped using Niti rotary protapers (Dentsply Maillefer, Ballaigues, Switzerland) with crown-down technique.
Postoperative radiograph showing the separation and divergence of the 4-rooted maxillary second molar.
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fig5
AH-Plus sealer (Dentsply DeTrey, Konstanz, Germany) and protaper gutta-percha. After placing a silver amalgam permanent restoration, a postoperative radiograph showed the unique palatal morphology (Figure 5).
Healing of draining sinus.
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fig6
One month recall of patient showed healing of draining sinus (Figure 6), and a porcelain-fused-to-metal crown was given.