Endodontic treatment of a mandibular canine with two roots
Vol. 52 No. 3 Suppl., 2011
This supplement was not sponsored by Outside Organizations.
ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY
Oana Cella Andrei, Ruxandra Margarit, Irina Maria Gheorghiu
Lower canine is a tooth with a robust, long root and very good implantation, making it a valuable abutment tooth for any type of prosthetic treatment. In order to treat it conservatively and to prevent its loss from the dental arch it is necessary to accomplish a correct and complete endodontic treatment, which involves knowledge of all its morphological variation. The mandibular canine usually presents one root with a single large canal centrally located. The possible anatomical variations are the existence of a single root with two canals and of two different roots, each having a canal. The incidence of lower canines with two roots is usually low, as described in various studies, but their presence in everyday practice shows that the clinician must consider them if he wants to prevent dental endodontic treatment failure. This article presents a relatively rare case of a patient whose right mandibular canine has two roots and two canals. Although the frequency of mandibular canines with two roots is very low, we must not forget that we can deal with such cases, which can obviously occur even in patients in our country, as the ones described in foreign specialty literature.
Corresponding author: Oana Cella Andrei, Lecturer, MD, PhD, e-mail: cella.andrei@gmail.com
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Lavinia Gheorman, D. Iliescu, Iuliana Ceausu, Daniela Paulescu, I. E. Plesea, V. Gheorman
We report and analyze a case of pregnancy associated with pre-existent diabetes mellitus and fetal congenital anomalies involving neural tube defect (NTD) and congenital heart defect (CHD). We discuss the early antenatal management of such high-risk pregnancies. The clinical course, maternal paraclinic profile and morpho-sonographic investigation of the fetus are described. A 28-year-old pregnant woman with pre-existing diabetes and a pre-pregnancy BMI 31 kg/m(2), without preconception counseling for optimization of glycemic control was evaluated in our center for first trimester genetic screening at 12 weeks of gestation. Considering a high-risk pregnancy, careful fetal morphological assessment by ultrasound was performed; the extensive examination using high-resolution probes, both by transabdominal and transvaginal approach, found hypoplastic left heart syndrome (HLHS) and open spina bifida (OSB). Both anomalies present important difficulties regarding first trimester diagnostic. The couple was informed and chose termination of pregnancy (TOP). We consider that an anomaly scan at 12-13 + 6 gestational weeks by expert operators should be offered to high-risk pregnancies, because it provides the chance to detect the majority of fetal anomalies. This offer for couples the option of an early decision about the management of pregnancy in cases of severe fetal anomalies; postnatal treatment could be discussed as well as TOP and if the latter is chosen, the maternal risk and the potential psychological burden are lowered, as compared with TOP performed in the mid-second trimester.
Corresponding author: Dominic Iliescu, Teaching Assistant, MD, PhD student, e-mail: dominic.iliescu@yahoo.com
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