It needs a thorough knowledge of root canal and its variables to achieve success in root canal treatment, together with diagnosis, treatment planning and clinical expertise. One of the possible variants of the root canal system is the C shape canal configuration . Its name came from the anatomical configuration in cross-section.
This condition has been described for the first time in literature by Cooke and Cox in 1979, although Weine et al., have reported that several doctors had already suggested the presence of this conformation in previous situations.
Most of the canals of this kind are commonly found in seconds mandibular molars, but such cross-sectional representation, may be noted even in the first lower molars, premolars, upper and lower, first and second upper molar and as last third molars, which have many anatomic variants.
Treatment of C-shape canal in the second mandibular molar
Video updated on Youtube by Antonis Chaniotis
The complexity of this configuration appears to be a challenge during root canal cleaning, cleaning and filling during the root canal therapy and may affect the long-term prognosis of the element. The recognition of a root canal configuration in the shape of C, before treatment can make the treatment more effectively, preventing irreparable damage which could put the tooth in grave danger.
The way for the success in endodontics revolves around knowledge, respect and care for the anatomy, careful cleaning, meticulously executed, adequate canal preparation and snap back as accurate as possible endodontium. To achieve these objectives, however, it is important to know more than the norm, exceptions of teeth.
As we have said the element more easily subject to the presence of a C shaped canal is the second mandibular molar, therefore we analyze in a short first of all its anatomy root canal “normal”.
Root canal anatomy of the second mandibular molar
The second maxillary molar has an access to the chamber which can be variable depending on the number of canals and roots; can be round, oval, triangular or quadrangular.
This element has different conformations, which makes each case to be framed in general rules difficult, requiring a case by case analysis.
It can present:
-A One mesial and distal canal;
-A Root with two or more canals;
-Three root canal entrances rotated;
-A Root and a single canal;
– “C-shape” configuration.
The shape and the number of roots are determined by the epithelial sheath of Hertwig. If the failure occurs by the epithelial root sheath of Hertwig to merge the lingual surface with the buccal roots may occur in the shape of C, which always contain a canal in the shape of C. However, there are also several other causes that contribute to the formation of a C-shape.
Endodontic textbooks claim that the C-shaped canal is not uncommon and this is confirmed by studies finding that its frequency between 2.7% and 8%.
It is rarely found in Caucasians and and is much more common in Asia.