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Updated: Sep 20, 2025

Guided Endodontics: Three-Dimensional Planning and Template-Aided Preparation of Endodontic Access Cavities
Published on: May 24, 2022
Successful individualized endodontic treatment of severely curved root canals in a mandibular second molar: A case
Lai-Jun Xu1, Jian-Ying Zhang1, Zi-Hua Huang1
1Hunan Key Laboratory of Oral Health Research; Hunan 3D Printing Engineering Research Center of Oral Care; Hunan Clinical Research Center of Oral Major Diseases and Oral Health; Academician Workstation for Oral-maxilofacial and Regenerative Medicine and Xiangya Stomatological Hospital; Xiangya School of Stomatology, Central South University, Changsha 410008, Hunan Province, China.
Background:
The incidence rate of severely curved root canals in mandibular molars is low, and the root canal treatment of mandibular molars with this aberrant canal anatomy may be technically challenging.
Case Summary:
A 26-year-old Chinese female patient presented with intermittent and occlusal pain in the left mandibular second molar. The patient had undergone filling restoration for caries before endodontic consultation. With the aid of cone beam computed tomography (CBCT), a large periapical radiolucency was observed, and curved root canals in a mandibular second molar were confirmed, depicting a severe and curved distolingual root. Nonsurgical treatments, including novel individualized preparation skills and techniques and the use of bioceramic materials as an apical barrier, were performed, and complete healing of the periapical lesion and a satisfactory effect were achieved.
Conclusion:
A case of severely curved root canals in a mandibular second molar was successfully treated and are reported herein. The complex anatomy of the tooth and the postoperative effect were also evaluated via the three-dimensional reconstruction of CBCT images, which accurately identified the aberrant canal morphology. New devices and biomaterial applications combined with novel synthesis techniques can increase the success rate of intractable endodontic treatment.

