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rev port estomatol med dent cir maxilofac . 2019;60(3):137-144 143

Figure 20. Obturation of the three distal root canals

Figure 22. Post -operative radiograph

ple of 4335 mesial roots. This review also found 22 studies
2
that analyzed the distal root. In a combined sample of 3378
2
distal roots, 62.7% had a single root canal. Despite not men-
tioning any prevalence for this condition, that research found
a few case reports of three canals in the distal root. 6,7,9 One
7
other study stated that the prevalence of the configuration
Figure 21. Pulp chamber floor after root canal filling with three distal root canals ranged from 0.2%, in the Sene-
galese population, to approximately 3.0%, in the Sudanese
population.
there were no signs of swelling and the patient was asymp- The mandibular first molars are the first posterior teeth
tomatic. A new disinfection protocol was performed, as well to erupt and, as a result, become more prone to carious le-
as root canal obturation (Figures 19, 20, 21 and 22). The patient sions, which may lead to endodontic treatment. An incorrect
was scheduled for a 12 -month follow -up but missed the ap- evaluation of the anatomy of a tooth under treatment may
pointment. However, after being contacted, he reported that lead to incomplete and incorrect endodontic procedures that
10
he had no complaints and the tooth was functional. may, in turn, lead to treatment failure. One study analyzed
the possible causes of endodontic treatment failures on a
sample of 493 teeth submitted to endodontic microsurgery.
Discussion and conclusions 19.7% of the analyzed teeth had canals that were not identi-
fied when the root section was performed. More recently, a

Although other anatomic configurations have been reported, study 11 assessed the prevalence of apical periodontitis in
the presence of three root canals appears to be the most root -filled teeth in a Brazilian subpopulation, using cone-
common configuration for mandibular first molars. 2,3,4 In a -beam computed tomography (CBCT). Of the included 2294
2
systematic review that analyzed this tooth anatomy, the teeth, 12.0% had at least one untreated missed canal. Un-
prevalence of two roots was higher than 85.0% in a combined treated canals were more frequent in maxillary molars, fol-
sample of 18.781 teeth. Three canals were present in 61.3% of lowed by mandibular molars. Moreover, the authors reported
the cases, four canals in 35.7% and five canals only in approx- that the odds for apical periodontitis to be present was over
2
imately 1.0%. When analyzing just the mesial root, 94.4% of six times greater in teeth with a missed canal. The same con-
the cases had two root canals, and 2.3% had three, in a sam- clusion was made.