Endodontic management of maxillary first molar having five root canals with the aid of spiral computed tomography

Abstract

A thorough knowledge of root canal anatomy is essential for the endodontic therapy.Aberrations in the root canal system, especially in multirooted teeth, can pose a considerable challenge to the endodontist during root canal treatment. The dentist should be familiar with various root canal configurations and their variations for successful endodontic therapy. It is important to evaluate each individual case for variations.There are rare variations in root canal number and configuration in maxillary molars, which could affect treatment outcome. The present case report presents the endodontic management of a maxillary first molar with a variant root canal anatomy, having five root canals, with mesiobuccal root havingtwocanals (Vertucci type II), distobuccal root having onecanal and the palatal root having twocanals (Vertucci type II). The variant root canal anatomywas confirmed using a spiral computed tomography (SCT).With 3D reconstruction of the SCT image of the tooth, it was possible to scrutinize the patency of the canal lumens, throughout the entire length of the palatal root.This case report highlights the value of a SCT scan as a supplement to plain radiographs for the accurate diagnosis and successful endodontic management of a complex morphological variation in root canals.It also serves to remind the clinicians that such anatomic variations should be kept in mind during the endodontic treatment of maxillary first molars.