Endodontic management of a maxillary first molar with three roots and seven root canals with the aid of cone-beam computed tomography

Abstract

Variation in root canal morphology, especially in maxillary first molar presents a constant challenge for a clinician in their detection and management. This case report describes the successful root canal treatment of a three rooted right maxillary first molar presenting with three canals each in the mesiobuccal and distobuccal roots and one canal in the palatal root. The clinical detection of this morphologic aberration was made using a dental operating microscope, and the canal configuration was established after correlating and computing the clinical, radiographic and cone-beam computed tomography (CBCT) scan findings. CBCT images confirmed the configuration of the canals in the mesiobuccal and distobuccal roots to be Al-Qudah and Awawdeh type (3-2) and type (3-2-1), respectively, whereas the palatal root had a Vertucci type I canal pattern. This report reaffirms the importance of careful examination of the floor of the pulp chamber with a dental operating microscope and the use of multiangled preoperative radiographs along with advanced diagnostic aids such as CBCT in identification and successful management of aberrant canal morphologies.

Endodontic management of a maxillary first molar with seven root canal systems evaluated using cone-beam computed tomography scanning

“…Nayak et al . [ 15 ] also reported similar finding of seven canals in a left maxillary first molar. Al-Qudah and Awawdeh type (3-2) and type (3-2-1) supplemental canal configurations were seen in mesiobuccal and distobuccal roots and Vertucci Type I (1-1) canal configuration (xx) in palatal root.…”

Maxillary first molar with 7 root canals diagnosed using cone-beam computed tomography

“…Anatomic variations are not uncommon in maxillary first molars, and additional canals in the distobuccal and palatal roots have been reported in the literature; however, case reports with more than 6 canals are not usual and only few cases have been previously published. 9 10 11 12 13 14 15 Diagnosis and management of these complexities present an endodontic challenge, and failure to identify and treat these extra canals can negatively influence treatment outcome. In these cases, careful examination of preoperative image exams can be helpful.…”

“…In contrast, maxillary first molars with more than 6 canals are rare, and only few cases have been reported in endodontic literature ( Table 1 ). 7 8 9 10 11 12 13 14 15 We present here a rare case report of a maxillary first molar with 7 separate canals: 3 canals in the mesiobuccal root, 2 canals in the distobuccal root, and 2 canals in the palatal root.…”

Unusual anatomy of permanent maxillary and mandibular molars: Case reports

“…Anatomical and morphological variations and rare abnormalities of roots and root canal systems had been shown in previous studies [1,2,3]. The literature shows that maxillary molars can present from the simplest to the extensively complicated root and root canal anatomy and morphology [8][9][10][11][12][13][14]. Not much difference was found for mandibular molars [6,[15][16][17][18][19].…”