Endodontic management of maxillary permanent molar C-shaped morphology

Aim: Report on the successful endodontic management of 4 permanent maxillary molars with a C-shape configuration of the root canal system.

Summary: Even though C-shaped anatomies are more commonly described in the mandibular molars, its occurrence in permanent maxillary molars has also been reported. Complexity of the root canal system may pose a difficulty in achieving proper chemo-mechanical debridement, and consequently jeopardize the success of endodontic therapy. Additional dedicated armamentarium can help the clinician recognize, assess, plan and better manage such complex configurations.

Key learning points

• Although of rare prevalence, clinicians must be aware and recognize the possible existence of a C-shaped root canal configuration in both first and second permanent maxillary molars.
• This anatomy can be attributed to an embryologic alteration that leads to the non-division of roots during the root formation stage of tooth formation.
• Further studies on the prevalence of the C-shaped configuration in permanent maxillary molars may contribute to a better understanding and, consequently, proper management of this morphology.
• Specific tools, such as the dental operating microscope and specific ultrasonic tips, as well as additional means of enhancing chemical debridement, are essential for the correct management of these intricate anatomies and appear to positively impact outcome of root canal treatment.