case_images: PMC11808330_01
case_images: A) Initial radiograph of maxillary second molar; B) Working length determination radiograph with five K-files; C) Final obturation with demonstrating arrows (MB: Mesiobuccal, DB: Distobuccal, P: Palatal, RE: Root-like enamel pearl); D) One year follow up radiograph
case_images: IEJ-20-e6-g001.jpg
case_images: PMC11808330_01_IEJ-20-e6-g001.jpg
case_images: F1
case_images: Additionally, obvious recurrent caries under mesial amalgam restoration of the maxillary right second molar and radiolucency at the apex of the mesiobuccal root were seen in radiographic and clinical examinations (Figure 1A). Then, on the same visit, the obturation was completed using gutta-percha cones and AH-26 sealer (Dentsply DeTrey; Konstanz, Germany) by cold lateral condensation technique (Figure 1C). The tooth remained asymptomatic and functional during the one-year follow-up period (Figure 1D).
case_images: Access cavity with demonstrating arrows (P: Palatal, RE: Root-like enamel pearl, MB: Mesiobuccal, DB: Distobuccal)
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case_images: PMC11808330_01_IEJ-20-e6-g002.jpg
case_images: F2
case_images: Tochigi-Ken, Japan). The floor of pulp chamber revealed five canal orifices, two in the buccal and three in the palatal (Figure 2), which were confirmed by a limited field of view CBCT (NewTom 3G, QR Srl, Verona, Italy) with a 110 kVp tube voltage and a 7.18 mAsec tube current.
case_images: A-D) Sagittal sections of CBCT image showing small root-like enamel pearl between palatal canals; E and F) Axial sections determine five canals of the maxillary second molar
case_images: IEJ-20-e6-g003.jpg
case_images: PMC11808330_01_IEJ-20-e6-g003.jpg
case_images: F3
case_images: Otherwise, the three palatal canals revealed two type IV canals in the Vertucci classification in palatal root and the next canal as palatal root-like enamel pearl (Figure 3).