Management of a mandibular second molar with vertucci type ii (root canal) configuration using fiber-reinforced direct composite: a case report

Blofoma Mohentaeses Veransa; Margareta Rinastiti

doi:10.24198/pjd.vol36no3.58665

Management of a mandibular second molar with vertucci type ii (root canal) configuration using fiber-reinforced direct composite: a case report

Blofoma Mohentaeses Veransa, Margareta Rinastiti

Abstract

Introduction: Vertucci Type II (root canal) configurations in mandibular second molars are rare. These anatomical variations complicate root canal preparation, irrigation, and obturation. The use of fiber-reinforced direct composite contributes to reinforcing teeth post-endodontic treatment, enhancing fracture resistance, and improving the long-term success of restorations, particularly in posterior teeth subjected to significant masticatory forces. This case report aims to present the management of root canal treatment procedures for a mandibular second molar with a Vertucci Type II configuration, and fiber-reinforced composite restorations through carpeting, and wallpapering techniques. Case Report: A 23-year-old female patient presented to the Conservative Dentistry Clinic, RSGM UGM-Prof Soedomo Yogyakarta, for treatment of her lower left second molar. She reported discomfort in the tooth, which had been previously restored two years prior. Six months before the examination, the restoration fractured causing pain. Although the pain has subsided, food debris often accumulated in the resulting cavity. Root canal treatment was performed using single-cone obturation technique with gutta percha and bioceramic sealer to achieve a hermetic sealing. In addition, restoration utilized polyethylene fiber reinforcement applied with wallpapering and carpeting techniques, combined with short fiber reinforced composite (SFRC) for dentin replacement, to enhance structural integrity and fracture resistance. The patient was monitored for one year. Conclusion: Root canal treatment of mandibular second molars with Vertucci type II configuration emphasizes the importance of understanding root canal anatomy, using CBCT for accurate evaluation. Optimal irrigation and hermetic obturation with a single-cone technique with a bioceramic sealer are crucial for treatment success. Post-endodontic restoration with polyethylene fiber-reinforced composite, incorporating short fiber-reinforced composite for dentin replacement, improves fracture resistance and maintains bond integrity.

Keywords

Vertucci type II; root canal treatment; direct composite; fiber reinforced

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References

Berisha A, Elezi KB, Sahatçiu H, et al. Endodontic Management of Mandibular Premolars with Root Canal Vertucci Type II and III Configuration: Two Case Reports. Int J of Biomedicine 2023;13(2):346–349; https://doi.org/10.21103/Article13(2)_CR2

Hepsenoglu YE. Mandibular second premolar with Vertucci Type II root canal morphological system: A case report. Turkish Endodontic J 2018;4(1); https://doi.org/10.14744/TEJ.2018.18189

Kim SY, Kim BS, Kim Y. Mandibular second molar root canal morphology and variants in a Korean subpopulation. Int Endod J 2016;49(2):136–144; https://doi.org/10.1111/iej.12437

Yang L, Han J, Wang Q, et al. Variations of root and canal morphology of mandibular second molars in Chinese individuals: a cone-beam computed tomography study. BMC Oral Health 2022;22(1); https://doi.org/10.1186/s12903-022-02299-8

Sofiani E, Setyawan E. Successful Root Canal Re-treatment of the Second Mandibular Premolar with type III of Vertucci Classification. Insisiva Dent J: Maj Kedokteran Gigi Insisiva 2024;13(1):41–47; https://doi.org/10.18196/di.v13i1.16418

Lewis C, Cohen PR, Bahl D, et al. Race and Ethnic Categories: A Brief Review of Global Terms and Nomenclature. Cureus 2023; https://doi.org/10.7759/cureus.41253

Madani ZS, Mehraban N, Moudi E, et al. Root and Canal Morphology of Mandibular Molars in a Selected Iranian Population Using Cone-Beam Computed Tomography. IEJ Iranian Endodontic J 2017;12(2):143–148; https://doi.org/10.22037/iej.2017.29.

Alyahya Y. A narrative review of minimally invasive techniques in restorative dentistry. Saudi Dent J 2024;36(2):228–233; https://doi.org/10.1016/j.sdentj.2023.11.005

Valizadeh S, Ranjbar Omrani L, Deliperi S, et al. Restoration of a Nonvital Tooth with Fiber Reinforced Composite (Wallpapering Technique). Case Rep Dent 2020;2020:1–6; https://doi.org/10.1155/2020/9619787

Scribante A, Vallittu PK, Özcan M. Fiber-Reinforced Composites for Dental Applications. Biomed Res Int 2018;2018:1–2; https://doi.org/10.1155/2018/4734986

Galina P, Tofan N, Andrei G, et al. clinical performance of resin composite restorations in posterior teeth: a review. Romanian J of Oral Rehabilitation n.d.;2024 16(2); https://doi.org/10.6261/RJOR.2024.2.16.57.

Abdulgani A, Azz A. Composite Resins in Posterior Teeth; Clinical Review, Case Study. American Research J 2024;4(1); https://doi.org/10.21694/2578-1448.24001.

Milosevic A, Burnside G. The survival of direct composite restorations in the management of severe tooth wear including attrition and erosion: A prospective 8-year study. J Dent 2016;44:13–19; https://doi.org/10.1016/j.jdent.2015.10.015

Bresser RA, Carvalho MA, Naves LZ, et al. Biomechanical behavior of molars restored with direct and indirect restorations in combination with deep margin elevation. J Mech Behav Biomed Mater 2024;152:106459; https://doi.org/10.1016/j.jmbbm.2024.106459

Kınıkoğlu İ, Kayacı ŞT, Arslan H. Short fiber reinforced composite on fracture strength of immature permanent anterior teeth with simulated regenerative endodontic procedures: an in vitro study. J of Clinical Pediatric Dent 2023;47(6):171–177; https://doi.org/10.22514/jocpd.2023.074

Bijelic-Donova J, Garoushi S, Lassila LVJ, et al. Crack Propagation and Toughening Mechanism of Bilayered Short-Fiber Reinforced Resin Composite Structure. Dent Mater J 2022;41(4):580–588; https://doi.org/10.4012/dmj.2021-321

Deliperi S, Alleman D, Rudo D. Stress-reduced direct composites for the restoration of structurally compromised teeth: Fiber design according to the “wallpapering” technique. Oper Dent 2017;42(3):233–243; https://doi.org/10.2341/15-289-T

Gomez F, Brea G, Gomez-Sosa JF. Root canal morphology and variations in mandibular second molars: an in vivo cone-beam computed tomography analysis. BMC Oral Health 2021;21(1):424; https://doi.org/10.1186/s12903-021-01787-7

Vertucci FJ. Root Canal Morphology and Its Relationship to Endodontic Procedures. In: Endodontic Topics 2005. https://doi.org/10.1111/j.1601-1546.2005.00129.x

Karobari MI, Parveen A, Mirza MB, et al. Root and Root Canal Morphology Classification Systems. Testarelli L. ed. Int J Dent 2021;2021:1–6; https://doi.org/10.1155/2021/6682189

Hernawatiningsih, Kristanti Y, Harman Subandhi D. Root Canal Treatment on Vertucci Type V Configuration-A Case Report. Nature And Material Science Development 2019;32.

Rajasekhara S, Nawabadkar S, Manjunath S, et al. Endodontic management of permanent mandibular second molar with Vertucci type II canal configuration: A rare case report. Int J of Oral Care and Research 2020;8(4):109; https://doi.org/10.4103/INJO.INJO_49_20

Gomes BPFA, Aveiro E, Kishen A. Irrigants and irrigation activation systems in Endodontics. Braz Dent J 2023;34(4):1–33; https://doi.org/10.1590/0103-6440202305577

Gyulbenkiyan E, Gusiyska a. Impact of the passive/active ultrasonic activation on the endodontic irrigants effectiveness - a review. J of IMAB - Annual Proceeding (Scientific Papers) 2023;29(1):4826–4831; https://doi.org/10.5272/jimab.2023291.4826

Siqueira Junior JF, Rôças I das N, Marceliano-Alves MF, et al. Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz Oral Res 2018;32(suppl 1):1–19; https://doi.org/10.1590/1807-3107bor-2018.vol32.0065

Nouroloyouni A, Samadi V, Salem Milani A, et al. Single Cone Obturation versus Cold Lateral Compaction Techniques with Bioceramic and Resin Sealers: Quality of Obturation and Push-Out Bond Strength. Pucci CR. ed. Int J Dent 2023;2023:1–8; https://doi.org/10.1155/2023/3427151

Suwartini T, Santoso J, Widyarman AS, et al. Efficacy of Bioceramic and Calcium Hydroxide-Based Root Canal Sealers against Pathogenic Endodontic Biofilms. Contemp Clin Dent 2022;13(4):322–330; https://doi.org/10.4103/ccd.ccd_198_21

Mohamed AR, Elmohsen MMA, Abi-Elhassan MH, et al. Clinical evaluation of direct resin composite restorations of endodontically treated molars using dual cured self-adhesive system with bulk fill composite versus incremental packing technique. Int J Health Sci (Qassim) 2022;3263–3288; https://doi.org/10.53730/ijhs.v6nS1.5468

Dawood S, Dawood A, Alawi R, et al. The Use of Fiber-Reinforced Composites for Restoration of Endodontically Treated Teeth: A Review. Malaysian J of Medicine and Health Sciences 2023;19(5):407–413; https://doi.org/10.47836/mjmhs.19.5.46

Josic U, D’Alessandro C, Miletic V, et al. Clinical longevity of direct and indirect posterior resin composite restorations: An updated systematic review and meta-analysis. Dental Materials 2023;39(12):1085–1094; https://doi.org/10.1016/j.dental.2023.10.009

Hofsteenge JW, Scholtanus JD, Özcan M, et al. Clinical longevity of extensive direct resin composite restorations after amalgam replacement with a mean follow-up of 15 years. J Dent 2023;130:104409; https://doi.org/10.1016/j.jdent.2023.104409

Vallittu P, O¨zcan M. Clinical Guide to Principles of Fiber-Reinforced Composites in Dentistry. 2017.

Sadr A, Bakhtiari B, Hayashi J, et al. Effects of fiber reinforcement on adaptation and bond strength of a bulk-fill composite in deep preparations. Dental Materials 2020;36(4):527–534; https://doi.org/10.1016/j.dental.2020.01.007

Alshetiwi DSD, Muttlib NAA, El-Damanhoury HM, et al. Adaptation of Relined Fiber Post Using Discontinuous Short Fiber-Reinforced Resin Composite to Restore Weakened Endodontically-Treated Premolars. European J Gen Dent 2023;12(2):89–96; https://doi.org/10.1055/s-0043-57245

Garoushi S, Sungur & S, Boz Y, et al. Influence of short-fiber composite base on fracture behavior of direct and indirect restorations. Clinical Oral Investigations 2021;25; https://doi.org/10.1007/s00784-020-03768-6

DOI: https://doi.org/10.24198/pjd.vol36no3.58665