Mandibular first molar teeth with Vertucci's type II configuration: A case of endodontic retreatment

Introduction: Knowledge on the anatomy of the root canals and an accurate interpretation of radiograph results are required before endodontic treatment. The mesial roots of the mandibular first molars commonly have two canals. These canals, however are merged in the apical root. This variation is called the Vertucci's type II configuration, and it has an incidence rate of 41.87%. Such variation was identified via clinical and radiographic examinations obtained using various angles. This study aimed to identify and manage the root canal treatment of the mandibular first molar with Vertucci's type II configuration. Case report: A 25-year-old female patient complained of pain in the left mandibular molar. In tooth 36, filling and a metal post were observed, and radiographic results showed that the tooth has been initially treated. Moreover, a radiolucency was observed in the distal root. Based on history taking and clinical examination, chronic apical abscess caused by non-hermetic endodontic treatment was observed in tooth 36. Endodontic retreatment was provided and the removal of the gutta-percha and metal post, root canal treatment, adequate obturation and restoration with fiber post and porcelain fused to the metal crown were initiated. Conclusion: Complex knowledge about the anatomy and morphology of the tooth is required for chemo-mechanical preparation to remove necrotic tissues and bacteria in the root canal and to produce adequate obturation. Thus, adequate post-treatment restoration can prevent root canal failure and maintain teeth for as long as possible in the jaw.