Search

Root canal calcification mainly occurs after physiologic dentin deposition throughout the aging process in elderlies or after traumatic injuries in young people, which can make endodontic treatment a challenge. The aim of this case report is to illustrate the successful endodontic treatment of severely calcified mandibular anterior teeth with the aid of “guided endodontics.” A 63-year-old Persian male patient was referred from the prosthetics department for root canal treatment of all six mandibular anterior teeth before his full-mouth reconstruction. Clinical examination showed severe attrition in all mandibular teeth with only the canines responding to sensitivity tests within the normal ranges. No tenderness to percussion and palpation or visible pocket depth was observed. Preoperative radiographs showed normal periodontal ligament spaces with no visible root canals within incisors, while the canines had moderately recessed pulpal spaces. A diagnosis of normal pulpoperiapical status was made. After precise clinical and radiographic examination, obtaining cone-beam computed tomographic images and digital intraoral scans, root canal treatments of the target teeth were performed using a custom-made three-dimensional model. A 4-month follow-up showed asymptomatic teeth, confirming that the endodontic guide is a useful tool to manage these cases safely. Previous case reports concerning “static guided endodontics” were also reviewed to identify the research gaps and the current limitations and benefits of the method.

Taurodontism is a dental anomaly characterized by an apical displacement of the pulp chamber floor, resulting in a large pulp chamber with short roots. It can be associated with certain syndromes and abnormalities, although it is common to occur as an isolated characteristic. This anomaly can occur along with other root canal system anomalies such as C-type configuration. The aim of this report is to present the successful endodontic management of a C-shaped mesotaurodontic mandibular molar and review the literature available on this matter. A 23-year-old Persian female was referred by her dental surgeon to complete the root canal treatment of her right mandibular first molar (#46). Clinical examination showed a temporized cavity with no response to pulpoperiapical tests or visible pocket depth while an elongated root trunk with slight periodontal ligament widening, incomplete obturation of the root canal system, and periapical radiolucency was evident on the intraoral radiograph. Cone-beam computed tomography (CBCT) revealed a taurodontic and type III C-shaped root canal configuration. With a diagnosis of previous treatment and asymptomatic apical periodontitis, the patient was scheduled for root canal retreatment. The same anomaly was discovered in other molar teeth on the panoramic radiograph taken before the primary treatment of tooth #46. At a 2-month follow-up session, the tooth was found asymptomatic clinically and radiographically. The past publications about the management of nonsyndromic taurodontic molars were also reviewed. The review of 29 similar articles showed that preoperative CBCT, magnification with illumination, along with active irrigation are helpful items in managing such cases.