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Background/purpose: Endodontic treatment success depends on treatment of all root canals, but the implementation status is affected by various factors. We examined whether the fee payment change affected the extra root canal endodontic treatment (EXRCT) in adult teeth in the National Health Insurance (NHI) system of Taiwan since 2008. The effect of hospital level, sex, and age on EXRCT was also examined. Materials and methods: Two longitudinal health insurance databases for 2005 and 2010 were used. Excluding third molars and endodontic retreatment, the EXRCT rate in permanent dentition were compared for different tooth positions, hospital levels, sex and age between 2005 and 2010. Results: In total, 80,995 teeth in 2005 and 76,018 in 2010 underwent root canal filling. The rate of EXRCT increased markedly from 2005 to 2010, particularly for the upper first molar (1.84% to 3.18%), lower first premolar (3.45% to 4.58%), lower first molar (12.4% to 18%), and lower second molar (0.95% to 1.87%). The difference between 2005 and 2010 remained statistically significant after adjustment for hospital level, sex, and age. The lower second molar had the highest adjusted odds ratio for the difference between 2005 and 2010 (1.99; CI: 1.49–2.66), followed by the upper first molar (1.91; CI: 1.55–2.35), lower first molar (1.60; CI: 1.47–1.75), and lower first premolar (1.38; CI: 1.11–1.72). Conclusion: The payment change of Taiwan NHI seems to encourage the use of EXRCT in molars. Hospital level, sex, and age also affected the rate of EXRCT.

Background/purpose Endodontic treatment success depends on treatment of all root canals, but the implementation status is affected by various factors. We examined whether the fee payment change affected the extra root canal endodontic treatment (EXRCT) in adult teeth in the National Health Insurance (NHI) system of Taiwan since 2008. The effect of hospital level, sex, and age on EXRCT was also examined. Materials and methods Two longitudinal health insurance databases for 2005 and 2010 were used. Excluding third molars and endodontic retreatment, the EXRCT rate in permanent dentition were compared for different tooth positions, hospital levels, sex and age between 2005 and 2010. Results In total, 80,995 teeth in 2005 and 76,018 in 2010 underwent root canal filling. The rate of EXRCT increased markedly from 2005 to 2010, particularly for the upper first molar (1.84% to 3.18%), lower first premolar (3.45% to 4.58%), lower first molar (12.4% to 18%), and lower second molar (0.95% to 1.87%). The difference between 2005 and 2010 remained statistically significant after adjustment for hospital level, sex, and age. The lower second molar had the highest adjusted odds ratio for the difference between 2005 and 2010 (1.99; CI: 1.49–2.66), followed by the upper first molar (1.91; CI: 1.55–2.35), lower first molar (1.60; CI: 1.47–1.75), and lower first premolar (1.38; CI: 1.11–1.72). Conclusion The payment change of Taiwan NHI seems to encourage the use of EXRCT in molars. Hospital level, sex, and age also affected the rate of EXRCT. [ABSTRACT FROM AUTHOR]

Brief Background The goal of root canal therapy is thorough cleaning and obturation of root canal system in all its dimensions. Knowledge of both normal and abnormal anatomy of the root canal system dictates the parameters for execution of root canal therapy and can directly affect the outcome of endodontic treatment. The maxillary first molar commonly has three roots and three or four root canals with mesiobuccal root having two canals. The palatal root having two canals is quite rare. This case report emphasizes one such aberrant anatomical situation which was missed initially during the treatment. Modification of the access cavity helped in locating the additional palatal canal. Knowledge of the unknown variation is essential as non treatment of one additional root or root canal can lead to failure of the endodontic treatment. [ABSTRACT FROM AUTHOR]

Although the possibility of three canals in maxillary second premolars is quite small, it must be taken into consideration in clinical and radiographic evaluations during endodontic treatment. This case report describes an unusual morphology of the three canals and two separated roots in maxillary second premolar in a Brazilian patient. A thirty-two year old male patient was referred to our clinic complaining of sensitivity to cold and pain at night in the second right upper premolar. The clinical examination revealed extensive distal caries. Percussion and cold tests were positive. The radiographic examination showed the presence of two roots. The diagnosis was an irreversible pulpitis. Root inspection revealed the existence of a third vestibular-palatal canal. The endodontic treatment was completed in a single session using manually serial instrumentation technique under sodium hypochlorite irrigation. Canals were obturated with thermoplasticized gutta-percha and sealed with zinc oxide and eugenol by lateral condensation technique. The presence of extra roots as a possible feature in maxillary second premolar should be considered during endodontic treatment. The instrumentation presented in this case report and the diagnosis methods were effective in successful three rooted second premolar treatment. [ABSTRACT FROM AUTHOR]