Endodontic management of maxillary permanent first molar with seven root canals – Report of two cases

Abstract

The maxillary first molar has been presented as a tooth with an enormous variety of root canal system configurations. The purpose of this paper is to present two cases of maxillary first molars displaying an uncommon seven root canal system morphology. After a proper access opening of the maxillary molars undergoing a root canal treatment, two dark developmental grooves were seen connecting both the main buccal canals to the palatal one. Under the magnification and illumination of a dental operating microscope, these two grooves were explored with ultrasonic tips, which allowed identifying several other root canal orifices in both buccal roots complemented by a single palatal root canal in one case, and two in the other. Embryological reasons and the best clinical approaches to these complex morphologies are also debated. Bearing in mind the complexities of internal anatomy can help maximize the success rates of endodontic treatment.