Aim: This Case Report describes two rare cases of clinical management of maxillary first molars with six root canals with special reference to radiographic interpretation and diagnosis.
Background: The study reports 2 clinical cases of endodontic treatment of maxillary first molars with six root canals.
Case Description: The access cavity was prepared using a slow speed round bur. The teeth were diagnosed with irreversible pulpitis and then anesthetized for an endodontic access cavity preparation. Clinical evaluation of the internal anatomy revealed 3 principle root canal systems: mesiobuccal (MB), distobuccal (DB), and palatal in each tooth. The working length was determined and the radiographs were taken for all the roots i.e mesiobuccal, distobuccal and palatal separately after placing instruments in each. The cleaning and shaping was performed using ProTaper Universal rotary instruments. Irrigation between each instrument was done. The canals were dried and obturation was performed using cold lateral compaction of gutta-percha and a resin-based sealer. The teeth were then restored with a posterior composite restoration. The patients were advised a full-coverage crown.
Conclusion: A good knowledge of tooth morphology, careful interpretation of angled radiographs, proper access cavity preparation and a detailed exploration of the interior of the tooth is needed to ensure a proper endodontic treatment.
Clinical Significance: Prevalence of teeth with such complex internal anatomy is a rare anomaly. However, a sound knowledge of the internal anatomy can aid in its adequate management.
Keywords: maxillary molar, six canals, altered anatomy
Endodontic Management of Maxillary Second Molar Tooth with a Single Root and Single Canal