Case Report: C-Shaped Canal In Mandibular Right Second Molar

C-shaped root canals, an anatomical variation commonly found in the mandibular second molars, present significant clinical challenges due to their complex root canal system. This case report demonstrates a standardized microscopic treatment protocol for a C-shaped root canal in the right mandibular second molar. A 45-year-old male presented with a one-week history of pain in the right mandibular posterior teeth. Examination revealed a deep distal caries in tooth #47 with positive probing pain, mild percussion pain, pain aggravated by hot/cold stimuli. Radiography showed a radiolucent pulp-proximal lesion in #47. Diagnoses chronic pulpitis in #47. #47 underwent caries removal and microscopic access, revealing a C-shaped canal system. Mechanical NiTi instrumentation and calcium hydroxide intracanal medication were performed. At follow-up, sodium hypochlorite with ultrasonic irrigation was used, followed by iRoot SP bioceramic sealer placement in the middle/apical third. Obturation was completed via cold lateral compaction and warm vertical compaction, confirmed radiographically as adequate. Composite resin restored the cavity. C-shaped canals, caused by incomplete Hertwig’s epithelial root sheath fusion, are prevalent in mandibular second molars. Microscopic examination identified a semicolon-shaped configuration with fused buccal canals and a separate lingual canal. iRoot SP, a biocompatible bioceramic, combined with warm vertical compaction, enhanced sealer penetration into isthmus areas and irregular anatomies. Microscopic determination of root canal configuration and bioceramic-based warm obturation are critical for managing C-shaped canals, ensuring effective disinfection and three-dimensional sealing.