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Successful root canal treatment depends on the thorough management of the canal anatomy. The use of periapical radiographs is essential to identify and monitor the canal's morphological variations. The C-shaped single canaled man-dibular 2nd molar probably requires a different regimen of treatment from the two rooted, three canaled version, as it i...
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Management of a mandibular second molar with dilacerated and S-shaped root canals Key words dilacerated root canal, integrated root canal procedure, problem solving, S-shaped root canal Newer NiTi rotary and reciprocating instruments have enabled the management of unusual and challenging root canal anatomies. While the use of these instruments has...
Unusual root canal anatomy always poses a diagnostic and treatment challenge.Therefore a thorough knowledge of root canal anatomical variations along with proper diagnosis, treatment planning and clinical expertise is the key to their successful management. The C‑shaped root canal configuration is one such aberrant canal anatomy, common in the mand...
An adequate and accurate knowledge about root canal morphology leads to a proper access opening, canal detection and working
length negotiation followed by enough irrigation, bio-mechanical preparation and exact obturation establishing a successful root
canal treatment. This case presents a rare case of a single round root canal system in a uni-roo...
Background and Aim: The aim of this study was to evaluate the morphological aspects of the root canal anatomy of the distal roots of mandibular first molars using micro computed tomography.
The radix entomolaris/paramolaris is the major anatomical variant in mandibular first molars. If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment. Hence, it is essential to anticipate and find all roots and root canals during root canal treatm...
Citations
... A C-shaped canal usually describes a certain anatomical configuration of a tooth's RC. The natural crevices found in tooth roots where blood vessels and nerves are housed are called RCs [2]. The C-shaped canal resembles the letter C when viewed in crosssection. ...
... This arrangement is frequently observed in mandibular molars, especially the second molars. A continuous ribbon-like or C-shaped construction is used in a C-shaped canal compared to the more common oval or circular RCs [2]. C-shaped canals can make RC treatments difficult. ...
... Two features, notable in the radiographs of this case, has been corroborated by literature for c-shaped canal 7,22 including: (a) instruments may exit at the furcation and (b) instruments tend to converge at the apex. 2 The former may appear as a perforation of the furcation, however, the mentioned approaches are available to rule out the possibility. ...
Key Clinical Message
Formulating an effective root canal treatment plan necessitates clinician awareness of the complexities of the root canal system and possible anatomic challenges. The C‐shaped canal variation accompanying the radicular lingual groove makes the lingual dentinal wall so thin that cleaning and shaping of canals require accurate management. This report presents endodontic treatment of a C‐shaped mandibular second molar diagnosed with pulpal necrosis and asymptomatic apical periodontitis, that initial radiographic assessment revealed extremely thin (0.3 mm) width of the lingual wall of the canals prone to perforation. Mechanical preparation was performed through the anti‐curvature technique and basically by chemical irrigation rather than mechanical instrumentation. The C‐shaped isthmus was prepared up to 25/02 rotary system without dentinal defect while maintaining adequate dentin thickness so as to not significantly reduce the strength of the root. Follow‐up radiographs showed normal periodontal ligament and lamina dura indicating significant healing of the periapical lesion.
... The "C"-shaped root is thought to be caused by a defect in the fusion of the Hertwig's sheath or by the deposition of cementum over time [9]. A "C"-shaped root always contains a "C"-shaped canal due to the fusion of either the buccal or lingual aspect of the mesial and distal roots while the two roots stay connected by an interradicular ribbon [10]. ...
The aim of this study was to investigate the root canal morphology of lower second molars in the Croatian subpopulation of the Zagreb region using cone-beam computed tomography (CBCT). We analyzed 3212 CBCT scans from the two radiology centers in Zagreb. The number of roots and root canals, the occurrence of C-shaped canals and additional roots were recorded. “C”-shaped roots were classified according to Melton classification. Canals in the mesial root were classified according to Vertucci. Lower second molars were found on 608 CBCT scans from a total number of 859. Among them, 78 (9.1%) had a “C”-shaped form. In the mesial roots, the frequencies of Vertucci types were: Type I in ninety-four cases (12.0%), Type II in three hundred and twenty cases (41.0%), Type III in six cases (0.8%), Type IV in three hundred and fifty-two cases (45.1%), Type V in three cases (0.4%), Type VI was found in four cases (0.5%) and Type VIII was found in one case (0.1%). Radix entomolaris and paramolaris were found in 29 (3.4%) lower second molars. The lower second molars in the Zagreb population show significant diversity in internal anatomy with a relatively high prevalence of “C”-shaped root canals and merged root canals in the mesial root.
... The C-shaped canal, which was first documented in endodontic literature by Cooke and Cox in 1979, is so named for the cross sectional morphology of the root and root canal. 2 This C-shaped canal is an anatomical variation of a root fusion and a type of taurodontism. This results from the failure of Hertwig's epithelial sheath to develop or fuse in the furcation area in the developing stage of the teeth. ...
... This makes the use of gutta-percha that has been thermoplasticized with electric spreaders or spreaders heated over an open flame, or delivered via injectable devices, more suitable. 2,18,19 Walid et al recounted using two pluggers at the same time to down pack the major canals in a C-shaped canal in 2000. A large plugger is placed on one of the seared master points while the other master point is down packed with a smaller plugger. ...
C-shaped canal is one of the most difficult situations with which the dentist is confronted during endodontic treatment of teeth. Recognition of unusual variation in the canal configuration is critical because it has been established that the root with a single tapering canal and apical foramen is the exception rather than rule. The early recognition of these configurations facilitates cleaning, shaping and obturation of the root canal system. "C" configuration, which is an important anatomic variation, presents a thin fin connecting the root canals. The present case series reports the successful management of C-shaped canals in mandibular second molars using cone-beam computed tomography (CBCT), sonic irrigation activation and different thermoplasticized gutta percha obturating techniques.
... The name was derived from the anatomical variation of root canals. 2 The phenomenon of C-shaped canal configuration has been pronounced more in permanent mandibular second molars heeded by mandibular premolars, maxillary molars, and the least by mandibular third molars. 3,4 Numerous etiological factors have been associated with the development of C-shaped canal morphology in dentistry since its introduction. ...
... After initial negotiation, Hyflex files were pre-curved according to the curvature as they tend to maintain the original canal curvature. [18][19][20] Case 5 was managed with difficulty as the canal was exceptionally wide with an ongoing resorption process. Special consideration to cold lateral compaction was given in case 3 and case 5 as there was continuing resorption process. ...
The C-shaped root canals offer greater negotiation, debridement, and obturation difficulty as they present with intercommunications, lateral canals, and reduced dentin thickness. Objective: This case series elaborates on the recognition that these varying configurations is important to enhance adequate cleaning, shaping, and sealing of the root canal. Case Reports: On clinical examination, all the teeth showed caries were nonresponsive to sensibility tests and toother diagnostic tests, suggestive of pulp necrosis with apical periodontitis. Conventional root canal treatment with different techniques and obturation systems have been used. This case series presents the successful management of various C-shaped configurations classified by Fan et al. and emphasizes the different treatment approaches for effective therapy. The cleaning and shaping process should always follow the canal anatomy to maintain the canal shape at the same point the primary and secondary curvatures and thin interconnections are negotiated, prepared, and sealed. Conclusion: The morphological variation existence and their different types and management should be known for improved healing and enhanced success of root canal treatment.
... Moreover, the post width should be minimized as well to avoid unnecessary removal and weakening of the tooth structure. Long-term clinical trials are required to study the clinical outcomes in diagnosis and treatment planning of such anomalies [10][11][12] . ...
... As a result, the fusion of the two roots is not uniform, and they are connected by a thin interradicular ribbon. The creation of a conical or prism-shaped root will occur if the sheath fails to fuse on both the buccal and lingual sides [3,4]. C-shaped mandibular premolars present a challenge for cleaning and shaping root canals because of their thin roots and the presence of concavities. ...
... It is seldom found in white people and commonly found in Asians than in whites. 7 Although C-shaped canal can be formed in any tooth, they are mostly found in permanent mandibular second molars. 2 A mandibular second molar has two roots and three root canals but great deal of variations could be seen. ...
Background: A successful endodontic treatment requires proper knowledge and thus management of aberrant root canal systems. The study was aimed to determine the prevalence of C shaped canals in mandibular second molars in South Indian population using cone beam computed tomography (CBCT) and trace this occurrence as geographical phenomenon.
... Knowledge of the anatomical complexity of the root canal system and its potential to vary can enhance the effective cleaning and shaping of the pulp canal space, thereby improving treatment efficiency and the long-term prognosis of the endodontic treatment [1,2]. One of the most challenging anatomical complexities of the root canal system is the C-shaped canal [3,4]. ...
Objectives: This retrospective study aimed to assess the prevalence of the C-shaped canal system in mandibular first and second molars in a Saudi Arabian population using cone-beam computed tomography (CBCT).
Materials and Methods: The sample included 300 CBCT images from adults aged 18 to 80 years (38.7 ± 17.9) (150 females and 150 males). All images were analyzed to detect the C-shaped root canal according to Fan’s
criteria. We also categorized our findings according to the gender and direction of the longitudinal groove. Data were reported as frequencies and percentages. The Chi-squared test was used to analyze proportional
differences, with the significance level set at ≤0.05.
Results: The C-shaped canals were observed in 146 mandibular first molars (24.33%) and 182 second molars (30.33%). Male patients had a significantly higher prevalence of C-shaped canals in mandibular second molars than females (P=0.003). The longitudinal groove was most typically detected on the root's lingual
surface (53.35%).
Conclusion: The incidence of the C-shaped canal in a Saudi Arabian population was 27.33% in the mandibular molars. The longitudinal groove was mostly on the lingual surface. Males showed a higher prevalence of the C-shaped canal than females.
