Tratamento endodôntico de primeiro molar superior com quatro raízes e trajeto fistuloso persistente com o auxílio da tomografia computadorizada de feixe cônico: um relato de caso

Abstract

A 19-year-old patient was referred for endodontic treatment of teeth 25 and 26. The patient presented with a fistula, which, with the aid of a gutta-percha cone, was associated with the apex region of tooth 25. A pre-operative periapical radiograph revealed a second premolar with one root and a first molar with three roots. A new radiograph with a digital sensor positioned vertically was taken, revealing an additional palatal root. Based on the radiographs and clinical findings, the diagnostic hypotheses of pulpal necrosis and abscess with fistula for teeth 25 and 26 were made, respectively. A cone beam computed tomography (CBCT) scan was performed to determine the location of the second palatal canal of tooth 26. Endodontic treatment was then carried out. Three sessions were necessary to complete the treatment. The patient returned after 6 months with no clinical symptoms and no presence of the fistula.