DOI QR코드

DOI QR Code

Radix mesiolingualis and radix distolingualis: a case report of a tooth with an unusual morphology

  • Nayak, Gurudutt (Department of Conservative Dentistry and Endodontics, Seema Dental College and Hospital) ;
  • Aeran, Himanshu (Department of Prosthodontics, Seema Dental College and Hospital) ;
  • Singh, Inderpreet (Dasmesh Institute of Research and Dental Science)
  • Received : 2016.04.27
  • Accepted : 2016.05.30
  • Published : 2016.11.30

Abstract

Variation in the root and canal morphology of the maxillary first molars is quite common. The most common configuration is 3 roots and 3 or 4 canals. Nonetheless, other possibilities still exist. The presence of an additional palatal root is rather uncommon and has been reported to have an incidence of 0.06 - 1.6% in varying populations studied. Whenever two palatal roots exist, one of them is the normal palatal root, the other is a supernumerary structure which can be located either mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). This case report describes successful endodontic treatment of a maxillary first molar with radix mesiolingualis and radix distolingualis. Identification of this variation was done through clinical examination along with the aid of multiangled radiographs, and an accurate assessment of this morphology was made with the help of a cone-beam computed tomography imaging. In addition to the literature review, this article also discusses the epidemiology, classifications, morphometric features, guidelines for diagnosis, and endodontic management of a maxillary first molar with extra-palatal root.

Keywords

References

  1. Ree M, Schwartz RS. The endo-restorative interface: current concepts. Dent Clin North Am 2010;54:345-374. https://doi.org/10.1016/j.cden.2009.12.005
  2. Burns RC, Buchanan LS. Tooth morphology and access openings. In: Cohen S, Burns RC, editors. Pathways of the pulp. 6th ed. St Louis: Mosby; 1987. p148.
  3. Gopikrishna V, Bhargavi N, Kandaswamy D. Endodontic management of a maxillary first molar with a single root and a single canal diagnosed with the aid of spiral CT: a case report. J Endod 2006;32:687-691. https://doi.org/10.1016/j.joen.2005.10.057
  4. Nayak G, Dahiya S, Singh I, Mohammad FH. Endodontic management of an unusual maxillary first molar with a single buccal root. J Contemp Dent Pract 2014;15:367-371. https://doi.org/10.5005/jp-journals-10024-1545
  5. Adanir N. An unusual maxillary first molar with four roots and six canals: a case report. Aust Dent J 2007;52:333-335. https://doi.org/10.1111/j.1834-7819.2007.tb00511.x
  6. Barbizam JV, Ribeiro RG, Tanomaru Filho M. Unusual anatomy of permanent maxillary molars. J Endod 2004;30:668-671. https://doi.org/10.1097/01.DON.0000121618.45515.5A
  7. Kottoor J, Velmurugan N, Surendran S. Endodontic management of a maxillary first molar with eight root canal systems evaluated using cone-beam computed tomography scanning: a case report. J Endod 2011;37:715-719. https://doi.org/10.1016/j.joen.2011.01.008
  8. Carlsen O, Alexandersen V. Radix mesiolingualis and radix distolingualis in a collection of permanent maxillary molars. Acta Odontol Scand 2000;58:229-236. https://doi.org/10.1080/000163500750051782
  9. Carlsen O, Alexandersen V. Radix paramolaris and radix distomolaris in Danish permanent maxillary molars. Acta Odontol Scand 1999;57:283-289. https://doi.org/10.1080/000163599428715
  10. Kottoor J, Nandini S, Velmurugan N. Maxillary first molar with three buccal roots evaluated with conebeam computed tomography: a rare case report. Gen Dent 2012;60:e404-e407.
  11. Rajalbandi S, Shingte SN, Sundaresh KJ, Mallikarjuna R. Aberration in the palatal root of the maxillary first molar. BMJ Case Rep 2013 Apr 30. doi: 10.1136/bcr- 2013-008641. [Epub ahead of print]
  12. Kottoor J, Velmurugan N, Ballal S, Roy A. Four-rooted maxillary first molar having C-shaped palatal root canal morphology evaluated using cone-beam computerized tomography: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;111:e41-e45.
  13. He W, Wei K, Chen J, Yu Q. Endodontic treatment of maxillary first molars presenting with unusual asymmetric palatal root morphology using spiral computerized tomography: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e55-e59. https://doi.org/10.1016/j.tripleo.2009.08.040
  14. Tomazinho FS, Baratto-Filho F, Zaitter S, Leonardi DP, Gonzaga CC. Unusual anatomy of a maxillary first molar with two palatal roots: a case report. J Oral Sci 2010;52:149-153. https://doi.org/10.2334/josnusd.52.149
  15. Chakradhar Raju RV, Chandrasekhar V, Singh CV, Pasari S. Maxillary molar with two palatal roots: two case reports. J Conserv Dent 2010;13:58-61. https://doi.org/10.4103/0972-0707.62627
  16. Holderrieth S, Gernhardt CR. Maxillary molars with morphologic variations of the palatal root canals: a report of four cases. J Endod 2009;35:1060-1065. https://doi.org/10.1016/j.joen.2009.04.029
  17. Gopikrishna V, Reuben J, Kandaswamy D. Endodontic management of a maxillary first molar with two palatal roots and a single fused buccal root diagnosed with spiral computed tomography - a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;105:e74-e78. https://doi.org/10.1016/j.tripleo.2007.11.022
  18. Baratto-Filho F, Fariniuk LF, Ferreira EL, Pecora JD, Cruz-Filho AM, Sousa-Neto MD. Clinical and macroscopic study of maxillary molars with two palatal roots. Int Endod J 2002;35:796-801. https://doi.org/10.1046/j.1365-2591.2002.00559.x
  19. Christie WH, Peikoff MD, Fogel HM. Maxillary molars with two palatal roots: a retrospective clinical study. J Endod 1991;17:80-84. https://doi.org/10.1016/S0099-2399(06)81613-4
  20. Di Fiore PM. A four-rooted quadrangular maxillary molar. J Endod 1999;25:695-697. https://doi.org/10.1016/S0099-2399(99)80359-8
  21. Thews ME, Kemp WB, Jones CR. Aberrations in palatal root and root canal morphology of two maxillary first molars. J Endod 1979;5:94-96. https://doi.org/10.1016/S0099-2399(79)80156-9
  22. Turp JC, Alt KW. Chapter 3.1. Anatomy and morphology of human teeth. In: Alt KW, Rosing FW, Teschler-Nicola M, editors. Dental anthropology. Fundamentals, limits and prospects. Wien: Springer-Verlag; 1998. p71-94.
  23. Cleghorn BM, Christie WH, Dong CC. Root and root canal morphology of the human permanent maxillary first molar: a literature review. J Endod 2006;32:813-821. https://doi.org/10.1016/j.joen.2006.04.014
  24. Neelakantan P, Subbarao C, Ahuja R, Subbarao CV, Gutmann JL. Cone-beam computed tomography study of root and canal morphology of maxillary first and second molars in an Indian population. J Endod 2010;36:1622-1627. https://doi.org/10.1016/j.joen.2010.07.006
  25. Yang B, Lu Q, Bai QX, Zhang Y, Liu XJ, Liu ZJ. Evaluation of the prevalence of the maxillary molars with two palatal roots by cone-beam CT. Zhonghua Kou Qiang Yi Xue Za Zhi 2013;48:359-362.
  26. Rouhani A, Bagherpour A, Akbari M, Azizi M, Nejat A, Naghavi N. Cone-beam computed tomography evaluation of maxillary first and second molars in Iranian population: a morphological study. Iran Endod J 2014;9:190-194.
  27. Gu Y, Wang W, Ni L. Four-rooted permanent maxillary first and second molars in a northwestern Chinese population. Arch Oral Biol 2015;60:811-817. https://doi.org/10.1016/j.archoralbio.2015.02.024
  28. Nikoloudaki GE, Kontogiannis TG, Kerezoudis NP. Evaluation of the root and canal morphology of maxillary permanent molars and the incidence of the second mesiobuccal root canal in Greek population using cone-beam computed tomography. Open Dent J 2015;31:267-272.
  29. Tian XM, Yang XW, Qian L, Wei B, Gong Y. Analysis of the root and canal morphologies in maxillary first and second molars in a Chinese population using cone-beam computed tomography. J Endod 2016;42:696-701. https://doi.org/10.1016/j.joen.2016.01.017
  30. Diamond M. Dental anatomy including anatomy of head and neck. 3rd ed. New York: MacMillan; 1952. p203-205.
  31. Versiani MA, Pecora JD, de Sousa-Neto MD. Root and root canal morphology of four-rooted maxillary second molars: a micro-computed tomography study. J Endod 2012;38:977-982. https://doi.org/10.1016/j.joen.2012.03.026
  32. Sabala CL, Benenati FW, Neas BR. Bilateral root or root canal aberrations in a dental school patient population. J Endod 1994;20:38-42. https://doi.org/10.1016/S0099-2399(06)80025-7
  33. Benenati FW. Maxillary second molar with two palatal canals and a palatogingival groove. J Endod 1985;11:308-310. https://doi.org/10.1016/S0099-2399(85)80163-1
  34. Calberson FL, de Moor RJ, Deroose CA. The radix entomolaris and paramolaris: clinical approach in endodontics. J Endod 2007;33:58-63. https://doi.org/10.1016/j.joen.2006.05.007
  35. Kannan SK, Suganya, Santharam H. Supernumerary roots. Indian J Dent Res 2002;13:116-119.
  36. Ahmed HM, Abbott PV. Accessory roots in maxillary molar teeth: a review and endodontic considerations. Aust Dent J 2012;57:123-131. https://doi.org/10.1111/j.1834-7819.2012.01678.x

Cited by

  1. Four-Rooted Maxillary First Molars: A Systematic Review and Meta-Analysis vol.2021, pp.None, 2016, https://doi.org/10.1155/2021/8845442