Five Root Canals for a Maxillary First Molar Tooth – A Case Report

Abstract

Introduction:Both external & internal anatomy of a tooth is an important aspect of root canal treatment. Failure to detect and treat the second MB2 canal system will result in a decreased long-term prognosis. 1 The main reasons for endodontic failure are apical percolation and presence of micro organisms caused by incomplete instrumentation, inadequate cleaning, insufficient canal obturation and presence of untreated canals 2 . Unusual root and root canal morphology associated with molar teeth have been recorded in several studies in the literature. 3,4 The maxillary first molar is the largest tooth in volume and one of the most complexes in root and canal anatomy 5 . In a literature review, the morphology of the MB root of 8399 maxillary first molar teeth was assessed in 34 studies where two or more canals were present in 56.8% in average of all studies and one canal in 43.1%. And single apical foramen was 61.6% while two apical foramina were 38.3 %. 3 The distobuccal and palatal root was reported in 14 studies included 2576 teeth where the common root canal system configuration of the DB root canal was single 98.3% and two canals 1.7%, and the single apical foramina was present 98% of the time as well as the palatal root with single canal 99% and single apical foramina 98.8% respectively. 3 Also some case reports have shown few anomalies like four rooted maxillary first molar presenting mesiobuccal, distobuccal and two palatal root and each root containing single canal also five rooted with two MB, one DB and two palatal and each root containing single canal. Abstract:This case report represents assessment and management of a maxillary left first molar tooth containing five root canals by endodontic treatment. In this case Mesiobuccal 2 (MB2), Mesiopalatal (MP) and Distobuccal (DB) canals were missed as well as very poor obturation at palatal and mesiobuccal1(MB1) canal during previous treatment history. Three mesiobuccal (MB1, MB2, and MP), DB and palatal canals were identified and endodontic retreatment was done followed by final restoration. This case provides an evidence of variations in the root canals of the mesiobuccal root of maxillary first molar tooth. Complete clinical and radiographic examination and adequate knowledge of the morphology of this kind of teeth is necessary for successful clinical outcome.

Endodontic Management of Maxillary First Molar with Five Root Canals, Including Two Distobuccal Root Canals: A Case Report

“…Nowadays, a whole range of tools are used to locate canals, including canal explorers, magnification, dye, multiple obliquely angled radiographs, dental operative microscopy, wear loupes, fiberoptic hand pieces, piezoelectric ultrasonic units, and computed tomography. The most important factor in locating a hidden canal, however, is creating an opening which will allow complete access and accurately ascertaining the internal and external anatomy of the tooth 10) . No cone beam computed tomography was performed in the present case as the patient was not financially able to afford it, so we were unable to confirm the presence of extra root canals or roots by this method.…”