How to preserve the mandibular second molar ――treatment of gutter-shaped root, combined endodontic and periodontal lesions, vertical bone absorption

Abstract

The mandibular second molars, due to their gutter shaped roots（ GSR） and a few other factors, tend to pose clinical challenges in cases of endodontic and periodontal problems. In fact dentists often waver between “tooth extraction and the preservation”. Discussed here is a case of a patient with systemic conditions which disallow surgical interventions; this report is to present difficulties and treatment precautions under such circumstances in the course of endodontic and periodontal care—in particular, diagnosis using CBCT data, root canal enlargement, and natural migration.