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

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. 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. 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. 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. Both digital analysis and printed models based on CBCT scans seemed fundamental to preclinically understand the abnormal endodontic anatomy.