Skip to main content
Top
Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Digital Volume Tomography | Case report

Endodontic management of maxillary first molar with protostylid: a rare case report

Authors: Yang Zhou, Ye Tao

Published in: BMC Oral Health | Issue 1/2023

Login to get access

Abstract

Background

A protostylid is a relatively rare dental developmental aberration characterized as an extra cusp located on the mesial half of the buccal surface of the molars. A protostylid is rarely to be reported due to its low rate of occurrence. This case report describes a patient referred for endodontic treatment due to the presence of a protostylid on the buccal surface of the maxillary first molar that induced apical periodontitis.

Case presentation

A 53-year-old female reported a 3-month history of pain of chewing with her upper left posterior teeth over 3 months. In the clinical examination, an abraded anomalous cusp-like structure was found on the buccal surface of tooth 26, Cone beam computed tomography (CBCT) revealed a supernumerary cusp with an intact root canal inside, which was fused with the mesiobuccal (MB) root canal in the middle of the root. In addition, extensive periapical radiolucency was observed around tooth 26. The tooth was diagnosed as apical periodontitis, and endodontic treatment was performed. The initial lesion in tooth 26 gradually healed over 1 year of observation.

Conclusions

To our knowledge, this case is the first to describe the endodontic management of a maxillary first molar with a protostylid and advances our understanding of supernumerary cusps. This case provides a reference for the treatment of protostylid.
Literature
3.
go back to reference Skinner MM, Wood BA, Hublin JJ. Protostylid expression at the enamel-dentine junction and enamel surface of mandibular molars of Paranthropus robustus and Australopithecus africanus. J Hum Evol. 2009;56(1):76–85.CrossRefPubMed Skinner MM, Wood BA, Hublin JJ. Protostylid expression at the enamel-dentine junction and enamel surface of mandibular molars of Paranthropus robustus and Australopithecus africanus. J Hum Evol. 2009;56(1):76–85.CrossRefPubMed
5.
go back to reference Appadurai R, Lingeshwar D, Missier MS, Maila SV. Permanent mandibular protostylid: a rare developmental anomaly and its overview. Indian J Dent Res. 2018;29(2):244–6.CrossRefPubMed Appadurai R, Lingeshwar D, Missier MS, Maila SV. Permanent mandibular protostylid: a rare developmental anomaly and its overview. Indian J Dent Res. 2018;29(2):244–6.CrossRefPubMed
6.
go back to reference Sedano HO, Ocampo-Acosta F, Naranjo-Corona RI, Torres-Arellano ME. Multiple dens invaginatus, mulberry molar and conical teeth. Case report and genetic considerations. Med Oral Patol Oral Cir Bucal. 2009;14(2):E69-72.PubMed Sedano HO, Ocampo-Acosta F, Naranjo-Corona RI, Torres-Arellano ME. Multiple dens invaginatus, mulberry molar and conical teeth. Case report and genetic considerations. Med Oral Patol Oral Cir Bucal. 2009;14(2):E69-72.PubMed
7.
go back to reference Moormann S, Guatelli-Steinberg D, Hunter J. Metamerism, morphogenesis, and the expression of Carabelli and other dental traits in humans. Am J Phys Anthropol. 2013;150(3):400–8.CrossRefPubMed Moormann S, Guatelli-Steinberg D, Hunter J. Metamerism, morphogenesis, and the expression of Carabelli and other dental traits in humans. Am J Phys Anthropol. 2013;150(3):400–8.CrossRefPubMed
8.
go back to reference Mostowska A, Kobielak A, Trzeciak WH. Molecular basis of non-syndromic tooth agenesis: mutations of MSX1 and PAX9 reflect their role in patterning human dentition. Eur J Oral Sci. 2003;111(5):365–70.CrossRefPubMed Mostowska A, Kobielak A, Trzeciak WH. Molecular basis of non-syndromic tooth agenesis: mutations of MSX1 and PAX9 reflect their role in patterning human dentition. Eur J Oral Sci. 2003;111(5):365–70.CrossRefPubMed
9.
go back to reference American Association of Endodontists. Guide To Clinical Endodontics 2019 update. 2019. American Association of Endodontists. Guide To Clinical Endodontics 2019 update. 2019.
10.
go back to reference Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new periapical index based on cone beam computed tomography. J Endod. 2008;34(11):1325–31.CrossRefPubMed Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new periapical index based on cone beam computed tomography. J Endod. 2008;34(11):1325–31.CrossRefPubMed
11.
go back to reference Salazar-Ciudad I, Jernvall J. A gene network model accounting for development and evolution of mammalian teeth. Proc Natl Acad Sci U S A. 2002;99(12):8116–20.CrossRefPubMedPubMedCentral Salazar-Ciudad I, Jernvall J. A gene network model accounting for development and evolution of mammalian teeth. Proc Natl Acad Sci U S A. 2002;99(12):8116–20.CrossRefPubMedPubMedCentral
12.
go back to reference Jiang K, Che C, Ding Z, Zeng S, Wang W, He X. Precision diagnosis and antidiastole on supernumerary cusp of tooth by CBCT. Surg Radiol Anat. 2016;38(9):1099–104.CrossRefPubMed Jiang K, Che C, Ding Z, Zeng S, Wang W, He X. Precision diagnosis and antidiastole on supernumerary cusp of tooth by CBCT. Surg Radiol Anat. 2016;38(9):1099–104.CrossRefPubMed
13.
go back to reference Kirthiga M. Ethnic Association of Cusp of Carabelli Trait and Shoveling Trait in an Indian Population. J Clin Diagnostic Res. 2016;10(3):Zc78–81. Kirthiga M. Ethnic Association of Cusp of Carabelli Trait and Shoveling Trait in an Indian Population. J Clin Diagnostic Res. 2016;10(3):Zc78–81.
14.
15.
go back to reference Liang RZ, Wu JT, Wu YN, Smales RJ, Hu M, Yu JH, Zhang GD. Bilateral maxillary fused second and third molars: a rare occurrence. Int J Oral Sci. 2012;4(4):231–4.CrossRefPubMedPubMedCentral Liang RZ, Wu JT, Wu YN, Smales RJ, Hu M, Yu JH, Zhang GD. Bilateral maxillary fused second and third molars: a rare occurrence. Int J Oral Sci. 2012;4(4):231–4.CrossRefPubMedPubMedCentral
16.
17.
go back to reference Gunduz K, Sumer M, Sumer AP, Gunhan O. Concrescence of a mandibular third molar and a supernumerary fourth molar: report of a rare case. Br Dent J. 2006;200(3):141–2.CrossRefPubMed Gunduz K, Sumer M, Sumer AP, Gunhan O. Concrescence of a mandibular third molar and a supernumerary fourth molar: report of a rare case. Br Dent J. 2006;200(3):141–2.CrossRefPubMed
18.
go back to reference Liedke GS, Spin-Neto R, Vizzotto MB, da Silveira PF, Wenzel A, da Silveira HE. Diagnostic accuracy of cone beam computed tomography sections with various thicknesses for detecting misfit between the tooth and restoration in metal-restored teeth. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(2):e131-137.CrossRefPubMed Liedke GS, Spin-Neto R, Vizzotto MB, da Silveira PF, Wenzel A, da Silveira HE. Diagnostic accuracy of cone beam computed tomography sections with various thicknesses for detecting misfit between the tooth and restoration in metal-restored teeth. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(2):e131-137.CrossRefPubMed
19.
go back to reference Lo Giudice R, Nicita F, Puleio F, Alibrandi A, Cervino G, Lizio AS, Pantaleo G. Accuracy of periapical radiography and CBCT in endodontic evaluation. Int J Dent. 2018;2018:2514243.CrossRefPubMedPubMedCentral Lo Giudice R, Nicita F, Puleio F, Alibrandi A, Cervino G, Lizio AS, Pantaleo G. Accuracy of periapical radiography and CBCT in endodontic evaluation. Int J Dent. 2018;2018:2514243.CrossRefPubMedPubMedCentral
20.
go back to reference Baratto Filho F, Zaitter S, Haragushiku GA, de Campos EA, Abuabara A, Correr GM. Analysis of the internal anatomy of maxillary first molars by using different methods. J Endod. 2009;35(3):337–42.CrossRefPubMed Baratto Filho F, Zaitter S, Haragushiku GA, de Campos EA, Abuabara A, Correr GM. Analysis of the internal anatomy of maxillary first molars by using different methods. J Endod. 2009;35(3):337–42.CrossRefPubMed
21.
go back to reference Suomalainen A, Pakbaznejad Esmaeili E, Robinson S. Dentomaxillofacial imaging with panoramic views and cone beam CT. Insights Imaging. 2015;6(1):1–16.CrossRefPubMedPubMedCentral Suomalainen A, Pakbaznejad Esmaeili E, Robinson S. Dentomaxillofacial imaging with panoramic views and cone beam CT. Insights Imaging. 2015;6(1):1–16.CrossRefPubMedPubMedCentral
22.
go back to reference Kaasalainen T, Ekholm M, Siiskonen T, Kortesniemi M. Dental cone beam CT: an updated review. Phys Med. 2021;88:193–217.CrossRefPubMed Kaasalainen T, Ekholm M, Siiskonen T, Kortesniemi M. Dental cone beam CT: an updated review. Phys Med. 2021;88:193–217.CrossRefPubMed
23.
go back to reference Yazıcıoğlu O, Ulukapı H. Management of a facial talon cusp on a maxillary permanent central incisor: a case report and review of the literature. J Esthet Restor Dent. 2014;26(6):374–81.CrossRefPubMed Yazıcıoğlu O, Ulukapı H. Management of a facial talon cusp on a maxillary permanent central incisor: a case report and review of the literature. J Esthet Restor Dent. 2014;26(6):374–81.CrossRefPubMed
24.
go back to reference Rampado ME, Tjäderhane L, Friedman S, Hamstra SJ. The benefit of the operating microscope for access cavity preparation by undergraduate students. J Endod. 2004;30(12):863–7.CrossRefPubMed Rampado ME, Tjäderhane L, Friedman S, Hamstra SJ. The benefit of the operating microscope for access cavity preparation by undergraduate students. J Endod. 2004;30(12):863–7.CrossRefPubMed
25.
go back to reference American Association of Endodontists. Microscopes Position Statement 2020. AAE Position Statement. 2020. American Association of Endodontists. Microscopes Position Statement 2020. AAE Position Statement. 2020.
26.
27.
go back to reference Khalighinejad N, Aminoshariae A, Kulild JC, Williams KA, Wang J, Mickel A. The effect of the dental operating microscope on the outcome of nonsurgical root canal treatment: a retrospective case-control study. J Endod. 2017;43(5):728–32.CrossRefPubMed Khalighinejad N, Aminoshariae A, Kulild JC, Williams KA, Wang J, Mickel A. The effect of the dental operating microscope on the outcome of nonsurgical root canal treatment: a retrospective case-control study. J Endod. 2017;43(5):728–32.CrossRefPubMed
28.
go back to reference Nurko C, Ranly DM, García-Godoy F, Lakshmyya KN. Resorption of a calcium hydroxide/iodoform paste (Vitapex) in root canal therapy for primary teeth: a case report. Pediatr Dent. 2000;22(6):517–20.PubMed Nurko C, Ranly DM, García-Godoy F, Lakshmyya KN. Resorption of a calcium hydroxide/iodoform paste (Vitapex) in root canal therapy for primary teeth: a case report. Pediatr Dent. 2000;22(6):517–20.PubMed
29.
go back to reference Ozalp N, Saroğlu I, Sönmez H. Evaluation of various root canal filling materials in primary molar pulpectomies: an in vivo study. Am J Dent. 2005;18(6):347–50.PubMed Ozalp N, Saroğlu I, Sönmez H. Evaluation of various root canal filling materials in primary molar pulpectomies: an in vivo study. Am J Dent. 2005;18(6):347–50.PubMed
30.
go back to reference Li J, Chen L, Zeng C, Liu Y, Gong Q, Jiang H. Clinical outcome of bioceramic sealer iRoot SP extrusion in root canal treatment: a retrospective analysis. Head Face Med. 2022;18(1):28.CrossRefPubMedPubMedCentral Li J, Chen L, Zeng C, Liu Y, Gong Q, Jiang H. Clinical outcome of bioceramic sealer iRoot SP extrusion in root canal treatment: a retrospective analysis. Head Face Med. 2022;18(1):28.CrossRefPubMedPubMedCentral
31.
go back to reference Rosen E, Goldberger T, Taschieri S, Del Fabbro M, Corbella S, Tsesis I. The prognosis of altered sensation after extrusion of root canal filling materials: a systematic review of the literature. J Endod. 2016;42(6):873–9.CrossRefPubMed Rosen E, Goldberger T, Taschieri S, Del Fabbro M, Corbella S, Tsesis I. The prognosis of altered sensation after extrusion of root canal filling materials: a systematic review of the literature. J Endod. 2016;42(6):873–9.CrossRefPubMed
32.
go back to reference European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006;39(12):921–30.CrossRef European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006;39(12):921–30.CrossRef
Metadata
Title
Endodontic management of maxillary first molar with protostylid: a rare case report
Authors
Yang Zhou
Ye Tao
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-03315-1

Other articles of this Issue 1/2023

BMC Oral Health 1/2023 Go to the issue