From:Marga Ree
Sent: Tuesday, January 24, 2006 2:28 PM
To: ROOTS
Subject: [roots] Weird anatomy 2nd max molar

This 17 year old boy complained about sensitivity in the ULQ, area 26-27. His dentist started a root canal treatment
in 26, but his complaints didn't subside. Then the boy was referred to a periodontist, because of a deep pocket
buccal of 27. Fortunately, the periodontist noticed a radiolucency being present on 27, and found that the tooth was
not responding to thermal tests. She referred the patient to me for a rct on 27. At first I thought it was a double
tooth, it looked like a gemination, but later on, I thought it might be a large tuberculum paramolare. Anyway, the
root canal system was kind of a C shape configuration, with a deep groove between the buccal and the palatal canal,
and a fin connecting the canals.Ca(OH)2 for 1 month, and the pocket had completely disappeared. Six months follow-up
rads show resolution of the lesion. What a great pity of the unnecessary endo in 26.............Marga

 

 

 

 


You get the fun ones marga.   Do you think there is an possibility those 3 extra cusps may have their own system.
That’s a lot of bulk of tooth structure to be avascular.  Obviously, 6 months healing is a good sign. - Gary

Good point Gary, I was thinking the same when I treated this tooth. During treatment, I looked whether I could see
signs of such a separate system, or maybe a connection  with the main rc system, but I failed to identify this. I
decided to wait for signs of healing, which occurred already after the first visit.
If this would not have happened, I was prepared to go back in.- Marga

I knew you would be.  5 months and counting! - Gary