The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 22 , ISSUE 12 ( December, 2021 ) > List of Articles


Endodontic Treatment of a Molar with Peculiar Anatomy: Case Study with CBCT and 3D Printed Model

Pietro Costamagna, Giorgia Carpegna, Caterina Bianchi, Andrea Baldi, Damiano Pasqualini, Nicola Scotti, Mario Alovisi

Keywords : Cone-beam computed tomography, Endodontics, Image-guided endodontics, Root canal therapy, Three-dimensional printing

Citation Information : Costamagna P, Carpegna G, Bianchi C, Baldi A, Pasqualini D, Scotti N, Alovisi M. Endodontic Treatment of a Molar with Peculiar Anatomy: Case Study with CBCT and 3D Printed Model. J Contemp Dent Pract 2021; 22 (12):1477-1482.

DOI: 10.5005/jp-journals-10024-3175

License: CC BY-NC 4.0

Published Online: 10-05-2022

Copyright Statement:  Copyright © 2021; The Author(s).


Aim: The aim of the study was to achieve the endodontic treatment of a second maxillary molar with abnormal anatomy through cone-beam computed tomography (CBCT) analysis and three-dimensional (3D) printing. Background: A patient arrived referring recurrent abscesses, spontaneous pain, and the difficulty to eat properly; a diagnosis of tooth necrosis was made. The periapical X-ray showed an abnormal anatomy of the tooth. Case description: The preoperative analysis of the tooth morphology was performed through CBCT analysis. The 3D scans were reconstructed through a dedicated software application (Mimics) to visualize the abnormal anatomy and detect the root canal morphology. Moreover, a 3D printed model was created to plan the clinical stage. Canal shaping was achieved with ProGlider and ProTaper Next techniques, and the root canal filling was performed with a carrier-based technique. Conclusion: The limits of this case were the low definition of the CBCT owned by the patient and the difficulties during the scouting of the canals due to the abnormal endodontic space complicated by narrow and flat canals. The software reconstruction allowed a 3D high-definition preclinical analysis of the tooth anatomy. Clinical significance: Both digital analysis and printed models based on CBCT scans seemed fundamental to preclinically understand the abnormal endodontic anatomy.

  1. Peters OA. Current challenges and concepts in the preparation of root canal systems. J Endod 2004;30(8):559–567. DOI: 10.1097/01.don.0000129039.59003.9d.
  2. Gutman JL. Minimally invasive dentistry (Endodontics). J Conserv Dent 2013;16(4):282–283. DOI: 10.4103/0972-0707.114342.
  3. Ozcan G, Sekerci AE, Cantekin K, et al. Evaluation of root canal morphology of human primary molars by using CBCT and comprehensive review of the literature. Acta Odontol Scand 2016;74(4):250–258. DOI: 10.3109/00016357.2015.1104721.
  4. Kuttler Y. Microscopic investigation of root apexes. J Am Dent Assoc 1955;50(5):544–552. DOI: 10.14219/jada.archive.1955.0099.
  5. Plotino G, Grande NM, Isufi A, et al. Fracture strength of endodontically treated teeth with different access cavity designs. J Endod 2017;43(6):995–1000. DOI: 10.1016/j.joen.2017.01.022.
  6. Venskutonis T, Plotino G, Juodzbalys G, et al. The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature. J Endod 2014;40(12):1895–1901. DOI: 10.1016/j.joen.2014.05.009.
  7. Ee J, Fayad MI, Johnson BR. Comparison of endodontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography. J Endod 2014;40(7): 910–916. DOI: 10.1016/j.joen.2014.03.002.
  8. Todd R. Cone beam computed tomography updated technology for endodontic diagnosis. Dent Clin North Am 2014;58(3):523–543. DOI: 10.1016/j.cden.2014.03.003.
  9. Patel S, Kanagasingam S, Mannocci F. Cone beam computed tomography (CBCT) in endodontics. Dent Update 2010;37(6):373–379. DOI: 10.12968/denu.2010.37.6.373.
  10. Venskutonis T, Plotino G, Juodzbalys G, et al. The importance of cone-beam computed tomography in the management of endodontic problems: a review of the literature. J Endod 2014;40(12):1895–1901. DOI: 10.1016/j.joen.2014.05.009.
  11. Oberoi G, Nitsch S, Edelmayer M, et al. 3D printing encompassing the facets of dentistry. Front Bioeng Biotechnol 2018;6:172. DOI: 10.3389/fbioe.2018.00172.
  12. Shah P, Chong BS. 3D imaging, 3D printing and 3D virtual planning in endodontics. Clin Oral Investig 2018;22(2):641–654. DOI: 10.1007/s00784-018-2338-9.
  13. Anderson J, Wealleans J, Ray J. Endodontic applications of 3D printing. Int Endod J 2018;51(9):1005–1018. DOI: 10.1111/iej.12917.
  14. Lee SJ, Jang KH, Spangberg LS, et al. Three-dimensional visualization of a mandibular first molar with three distal roots using computer-aided rapid prototyping. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;101(5):668–674. DOI: 10.1016/j.tripleo.2005.06.013.
  15. van der Meer WJ, Vissink A, Ng YL, et al. 3D computer aided treatment planning in endodontics. J Dent 2016;45:67–72. DOI: 10.1016/j.jdent.2015.11.007.
  16. Byun C, Kim C, Cho S, et al. Endodontic treatment of an anomalous anterior tooth with the aid of a 3-dimensional printed physical tooth model. J Endod 2015;41(6):961–965. DOI: 10.1016/j.joen.2015.01.016.
  17. Kato H, Kamio T. Diagnosis and endodontic management of fused mandibular second molar and paramolar with concrescent supernumerary tooth using cone-beam CT and 3-D printing technology: a case report. Bull Tokyo Dent Coll 2015;56(3):177–184. DOI: 10.2209/tdcpublication.56.177.
  18. Tutino F, Alovisi M, Bernanrdi M, et al. Micro-CT evaluation of ProTaper Next and WaveOne Gold shaping in maxillary first molars curved canals: an in vitro study. Giornale Italiano di Endodonzia 2019;33(1):65–69. DOI: 10.32067/gie.2019.33.01.09.
  19. Alovisi M, Pasqualini D, Carpegna G, et al. The influence of brushing movement on geometrical shaping outcomes: a micro-CT study. Appl Sci 2021;10(14):4805. DOI: 10.3390/app10144805.
  20. Alovisi M, Cemenasco A, Mancini L, et al. Micro-CT evaluation of several glide path techniques and ProTaper Next shaping outcomes in maxillary first molar curved canals. Int Endod J 2017;50(4):387–397. DOI: 10.1111/iej.12628.
  21. Elnaghy AM, Elsaka SE. Evaluation of root canal transportation, centering ratio, and remaining dentin thickness associated with ProTaper Next instruments with and without glide path. J Endod 2014;40(12):2053–2056. DOI: 10.1016/j.joen.2014.09.001.
  22. Pasqualini D, Alovisi M, Cemenasco A, et al. Micro-computed tomography evaluation of ProTaper Next and BioRace shaping outcomes in maxillary first molar curved canals. J Endod 2015;41(10):1706–1710. DOI: 10.1016/j.joen.2015.07.002.
  23. Zhao D, Shen Y, Peng B, et al. Root canal preparation of mandibular molars with 3 nickel-titanium rotary instruments: a micro-computed tomographic study. J Endod 2014;40:1860–1864. DOI: 10.1016/j.joen.2014.06.023.
  24. Alovisi M, Pasqualini D, Scotti N, et al. Micro-CT evaluation of rotary and reciprocating glide path and shaping systems outcomes in maxillary molar curved canals. Odontology 2021. DOI: 10.1007/s10266-021-00631-2.
  25. Carpegna G, Rigolone M, Pasqualini D, et al. Case report: C-shaped management with Thermafil system. G Ital Endod 2013;27(1):54–58. DOI: 10.1016/j.gien.2013.05.007.
  26. Pasqualini D, Scotti N, Mollo L, et al. Microbial leakage of gutta-percha and ResilonTM root canal filling material: a comparative study using a new homogeneous assay for sequence detection. J Biomater Appl 2008;22(4):337–352. DOI: 10.1177/0885328207077411.
  27. Lara Mendes STO, Barbosa CFM, Santa-Rosa CC, et al. Guided endodontic access in maxillary molars using cone beam computed tomography and computer aided design/computer-aided manufacturing system: a casa report. J Endod 2018;44(5):875–879. DOI: 10.1016/j.joen.2018.02.009.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.