MESOTAURODONTIC PRIMARY SECOND MOLARS: A CASE REPORT

as taurodontic. Endodontic treatment of taurodontic teeth is a difficult task. This article discloses, a 5-year-old child with a bilateral Mesotaurodontic primary second molar.

The prevalence rate of taurodontismis variable in both adults and children,approximately 0.5-46% and 0.3%. Based on the displacement of the pulpal floor, the taurodontic teeth are classified by Shawashypotaurodontic, mesotaurodontic, and hypertaurodontic. According to Seow and Lai, taurodontic teeth werealso classified using a biometric method. A tooth with a Crown Body and Root ratio of >1.10 was categorised as taurodontic. Endodontic treatment of taurodontic teeth is a difficult task. This article discloses, a 5-year-old child with a bilateral Mesotaurodontic primary second molar.
The syndromes associated with taurodontismare amelogenesisimperfecta, Down's syndrome, ectodermal dysplasia, Klinefelter syndrome, tricho-dento-osseous syndrome, Mohr syndrome, Wolf-Hirschhorn syndrome, and Lowe syndrome 3 . The clinical diagnosis isimpracticable, so the better and the ideal way for identification is through radiograph. This paperdiscloses a case with bilateral mesotaurodontism involving maxillary and mandibular deciduous second molars.

Case Report
A female patientof 5-year-old who reported to the Outpatient clinic of the Department of Pedodontics and Preventive Dentistry, had a chief complaint of extraoral swelling and pain on the lower left back tooth for the past 2 days. The dental or medical history of the patient was non-contributory and her developmental milestones were normal.On intraoral examination, a bilateral deep carious lesion in the mandibular deciduous second molar (75,85) was appreciated. The teeth were tender on vertical percussion with observable swelling and no sinus tract. IOPA revealed that mandibular left and right primary second molars (75,85) had an enlarged pulp chambers with short  Fig. 1,2]. The Crown body and root ratio of 75, 85 were measured using Adobe photoshop CS6 extended,which was around 1.45 and 1.58, respectively, and classified as Mesotaurodont 4 ,according to Seowand Lai classification [ Fig. 3a,b]. Bothclinical and radiographic findingsrevealed adento-alveolar abscess of Mesotaurodontic mandibular deciduous second molars (75,85). Multi-visit pulpectomy followed by placement of a stainless steel crown was planned. The tooth was anesthetized and the access was opened. The pulp tissue was extirpated and irrigated with 2.5% sodium hypochlorite. A working length was estimated and biomechanical preparation was done followed by obturation with Endoflas FS (Sanlor and Cia. S.en C.S., Cali, Colombia) [ Fig. 4a, b]. The pulpectomy was followed by restoration of the teeth with the placement of stainless steel crowns [ Fig. 5].

Discussion:-
There are different classification systems to assess the severity of taurodontism, in this case report we have used Seow and Lia 4 classification system and categorised it as mesotaurodontic,the ratio of crown body and root of the teeth were 1.45 and 1.58 (<2.0). The mandibular primary molars were measured because the outline is clear. The root morphology of the maxillary molars was superimposed on the zygomatic bone, causing burdensome to calculate the Crown Body and root ratio.The differential diagnosis of taurodontism is dentine dysplasia, which has similar radiographic featureswith a larger pulp chamber.This condition is less appreciated in elderly people and those with a fibrous diet, because of thedeposition of secondary and tertiary dentine 5 .
Access opening was similar to a normal tooth, but the procedures like orifice location, pulp extirpation, negotiation, instrumentation, and obturation were challenging. Increasedhemorrhage during access opening may be mistaken for perforation. Because of the complexity of the root canal anatomy, complete filling of the root canal system in taurodontic teeth is challenging. In this case report, Endoflas FS (Sanlor and Cia. S.en C.S., Cali, Colombia) was used as an obturating material because of its better resorbable properties similar to the natural primary root and to prevent the fast resorbable, hollow tube effect caused by other obturating materials.

Conclusion:-
It is very essentialto be aware of all dental anomalies especially, which are difficult to diagnose like taurodontism, which helps to detect any associated syndromes and other systemic conditions.

Declaration of parent consent
Informed consent forms were written and obtained from parents reporting to publishtheir daughter's images and clinical information.
Why this paper is important? 1. To provide knowledge on the dental anomaly which is difficult to diagnose. 2. Classifying the anomaly might help in treatment planning.
3. Difficulties encountered in treating this anomaly are discussed.