Endodontic management of maxillary first molar with seven root canals diagnosed using cone-beam computed tomography: A case report

Abstract

Aim and objective: To present the endodontic treatment of maxillary right first molar with three roots and seven root canals diagnosed with cone-beam computed tomographic imaging and its successful management. Background: The anatomic complexities and variations of maxillary first molar reported vastly in the literature are constant challenges for successful endodontic therapy. Detection of all the root canals and their disinfection is important for proper healing and long-term survival of the tooth. CBCT imaging is being used extensively over the past two decades for the diagnosis of teeth with multiple root canals. The use of CBCT and various diagnostic tools for the successful management of a maxillary first molar with multiple root canals is discussed herein. Case description: This case report represents an unusual morphology of three roots and seven root canals in the maxillary first molar. A rare configuration of two mesiobuccal, two distobuccal, and three palatal root canals is reported. The diagnosis was done using multiple angulated radiographs and CBCT imaging. Nonsurgical endodontic treatment was performed followed by a full-coverage porcelain crown. Conclusion: Clinicians should always be mindful of various possible aberrations in the canal morphology of maxillary molars. This necessitates the use of various diagnostic tools like CBCT and dental operating microscope (DOM). The use of these aids led to successful diagnosis and treatment in the present case, thereby avoiding possible endodontic failure. Clinical significance: This case report along with the literature discusses and highlights the fact that maxillary first molars have the highest incidence of additional root canals. It also signifies the importance of CBCT and DOM as essential diagnostic tools in detecting the additional canals.