PIRES, Amanda Carolina Dias Oliveira; COSTA, Natália Fernandes dos Santos; FERNANDES, Raphaela Gontijo Andrade
Abstract:
Periapical abscess with fistula in an upper molar tooth is a clinical
condition that originates from infection of the dental pulp, resulting in the formation of
pus in the region around the tooth root. This condition not only causes severe pain,
swelling, and discomfort, but it can also lead to serious systemic complications if not
treated properly. The challenge intensifies when the infection is associated with the
presence of a fourth channel (MV2) in the maxillary first molar. Objective: The
objective of this study was to review the literature on the main complications of an
upper molar with an unfilled fourth canal. Methodology: This study consists of a
literature review carried out in the Pubmed, MedLine, Scielo, Google Scholar,
LILACS databases, using the keywords: "fourth canal", "periapical abscess" and
"computed tomography". Results: The results indicate that periapical abscess may
complicate diagnosis and treatment of infections. In addition, the fourth canal of the
maxillary molar poses a significant challenge to endodontics, making clinical
management more complex. Conclusion: This review highlights the importance of
imaging tests, such as cone beam computed tomography, for the identification of
these anatomical conditions. It is concluded that an early diagnosis and treatment
adapted to the patient's needs are essential to prevent the progression of infections
and complications associated with these anomalies.
