Endodontic management of mandibular first molar with six root canals with an aid of Cone Beam Computed Tomography: A case report
Mandibular molar with six root canals.
Keywords:
CBCT, Magnification, Root canal.
Abstract
The mandibular first molars show many anatomical variations. Normally, they have three or four root canals and rarely have five or more root canals. The present case report highlights a rare anatomical configuration with six root canals (3 mesial and 3 distal) in the mandibular right first molar diagnosed during endodontic treatment using a dental operating microscope and confirmed with the help of cone‑beam computed tomography (CBCT) images. This case report revealed an increasing possibility of detecting additional canals through the magnification of the microscope and the improvement of CBCT diagnostic technology. Clinicians should have a thorough knowledge of the root canal system and internal anatomy and be alert about the possible existence of any variation in the canal morphology because it determines the successful outcome of endodontic treatment.
References
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2. Cleghorn BM, Goodacre CJ, Christie WH. Morphology of teeth and their root canal systems. J Endod. 2008;6:151-210.
3. Malagnino V, Gallottini L, Passariello P. Some unusual clinical cases on root anatomy of permanent maxillary molars. J Endod. 1997 Feb 1;23(2):127-8.
4. Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S, Meyers J. A 5yr clinical investigation of second mesiobuccal canals in endodontically treated and retreated maxillary molars. J Endod. 2005 Apr;31(4):262-4.
5. Ferreira CM, de Moraes IG, Bernardineli N. Three-rooted maxillary second premolar. J Endod. 2000 Feb 1;26(2):105-6.
6. Maggiore F, Jou YT, Kim S. A six-canal maxillary first molar: case report. Int Endod J. 2002 May;35(5):486-91
7. De Pablo ÓV, Estevez R, Heilborn C, Cohenca N. Root anatomy and canal configuration of the permanent mandibular first molar: clinical implications and recommendations. Quintessence Int. 2012 Jan;43(1):15-27.
8. Kottoor J, Paul KK, Mathew J, George S, Mathew J, Roy A. A permanent mandibular second molar with seven root canal systems. Quintessence Int. 2014 May;45(5):381-3.
9. Ricucci D. Three independent canals in the mesial root of a mandibular first molar. Endod Dent Traumatol. 1997 Feb;13(1):47-9.
10. Barletta FB, Dotto SR, Reis MD, Ferreira R, Travassos RM. Mandibular molar with five root canals. Aust Endod J. 2008 Dec;34(3):129-32.
11. Chandra SS, Rajasekaran M, Shankar P, Indira R. Endodontic management of a mandibular first molar with three distal canals confirmed with the aid of spiral computerized tomography: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endodo. 2009 Oct;108(4): e77-81.
12. Fabra‐Campos H. Three canals in the mesial root of mandibular first permanent molars: a clinical study. Int Endod J. 1989 Jan;22(1):39-43.
13. Gulabivala K, Opasanon A, Ng YL, Alavi A. Root and canal morphology of Thai mandibular molars. Int Endod J. 2002 Jan;35(1):56-62.
14. De Moor RJ, Deroose CA, Calberson FL. The radix entomolaris in mandibular first molars: an endodontic challenge. Int Endod J. 2004 Nov;37(11):789-99.
15. Azim AA, Deutsch AS, Solomon CS. Prevalence of middle mesial canals in mandibular molars after guided troughing under high magnification: an in vivo investigation. J Endod. 2015 Feb;41(2):164-8.
16. Izaz S, Nagesh B, Sunil CHB, Dasari B. Endodontic management of a hidden middle distal canal in mandibular first molar with post-operative CBCT—a case report. Indian J Conserv Endod 2016 Jul-Sep;1(2):65-8.
17. Forner Navarro L, Luzi A, Almenar García A, Hervás García A. Third canal in the mesial root of permanent mandibular first molars: review of the literature and presentation of 3 clinical reports and 2 in vitro studies. Med Oral Patol Oral Cir Bucal.2007 Dec;12(8): E605-9.
18. Krasner P, Rankow HJ. Anatomy of the pulp-chamber floor. J Endod. 2004;30(1):5-16
19. Chogle S, Zuaitar M, Sarkis R, Saadoun M, Mecham A, Zhao Y. The recommendation of cone-beam computed tomography and its effect on endodontic diagnosis and treatment planning. J Endod. 2020 Feb;46(2):162-8.
Published
2025-10-18
How to Cite
Bharati, N., Hans, M. K., Pandey, R., & Singh, S. P. (2025). Endodontic management of mandibular first molar with six root canals with an aid of Cone Beam Computed Tomography: A case report . UNIVERSITY JOURNAL OF DENTAL SCIENCES, 11(3), 76-80. https://doi.org/10.21276/ujds.2025.v11.i3.16
Section
Case Reports
