Four rooted maxillary second molar is a rare condition. A research of 1,200 maxillary second molars found only 0.4% of the sample with this condition. In a tooth with two palatal roots, one of them is the normal palatal root, while the other is a supernumerary structure which can be found mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). Objective: to describes a successful root canal treatment of a maxillary second molar with radix mesiolingualis. Final restoration using a short fiber-reinforced composite as the bottom structure under the onlay composite direct restoration. Case report: A 39-year old female patient complained of pain continuously for the past two weeks in her right maxillary second molar (tooth #17). Clinical examination revealed a deep mesioocclusal caries lesion and presence of extra cusps on the palatal surface of the crown. Conclusion: Crown with extra cusps relatively larger compared to a normal crown. It could be indicated the additional palatal roots. Those variations could be identified by clinical and radiographic examination, while more accurate assessment with CBCT imaging. The right material was required to support function and strengthen the tooth after root canal treatment.
1. Tsujimoto Y. Forms of roots and root canals in endodontic theraphy. 2009.
2. Karamifar K, Azimi S, Dashti H. Root canal treatment of a maxillary second molar with two palatal roots : A case report. J Res Dent Sci. 2010: 1: 37-40.
3. Nayak G, Aeran H, Singh I. Radix mesiolingualis and radix Distolingualis: A Case Report of a tooth with an unusual morphology. Restorative Dent Endod. 2016: 322-331.
4. Shok r i A , Mor t a z av i H , Ba h a r va nd M, Movahhedian A. Tooth abnormalities An Overview of More Than 20 Developmental and Acquired Disorders. Int J Clin Dent. 2014; 4, number 4: 346-362.
5. Garg N, Garg A. Textbook of Endodontics. 3rd Ed. New Delhi India: Jaypee Brother Medical Publisher; 2014: 147.
6. Carlsen O. Alexandersen V. Radix mesiolingualis and radix distolingualis in a collection of permanent maxillary molars. Acta Ondontol Scand. 2000: 58: 229-236.
7. He W, Wei K, Chen J, Yu Q. Endodontic treatment of maxillary first molars presenting with unusual asymmetric palatal root morphology using computerized tomography: A case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011: 111: e41-e45.
8. Garg N, Garg A. Textbook of Operative Dentistry. 2nd Ed. New Delhi India: Jaypee Brother Medical Publisher; 2013: 310.
9. Garaushi S, sailynoja E, Vallittu PK, Lassila LVJ. Physical properties and depth of cure of a new short fiber reinforce composite. Dent Mater. 2013: 29:835-841.
10. Garaushi S, Mangoush E, Vallittu PK, Lassila LVJ. Short fiber reinforced composite : A new alternative for direct onlay restorations. The Open Dent J. 2013: 7 :181-185.
11. Garaushi S, Gargaum A, Vallittu PK, Lassila LVJ. Short fiber-reinforced composite restorations: A review of the current literature. Dent Mater. 2018: 7 :181-185.
Desire Octarina, L., Endra Untara, T., & Mulyawati, E. Root Canal Treatment of the Maxillary Second Molar with an Unusual Morphology: A Case Report. J Dent Indones. 2020;27(2): 91-97