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Case Reports
. 2016 Apr-Jun;7(2):255-7.
doi: 10.4103/0976-237X.183055.

Endodontic management of mandibular first molar with seven canals using cone-beam computed tomography

Ankur Mahesh Banode  1 , Vandana Gade  1 , Sanjay Patil  1 , Jaykumar Gade  2
Affiliations
Case Reports

Endodontic management of mandibular first molar with seven canals using cone-beam computed tomography

Ankur Mahesh Banode et al. Contemp Clin Dent. 2016 Apr-Jun.

Abstract

The endodontic treatment of a mandibular molar with aberrant canal configuration can be diagnostically and clinically challenging. Successful endodontic therapy thus depends on the clinician's ability to anticipate and look for these aberrant variations. A mandibular first molar with seven canals represents a rare anatomical variant, particularly when four canals are found in distal root. Based on in vitro studies, its incidence is reported to be between 0.2% and 3%. With the advent of cone-beam computed tomography (CBCT) as an adjunctive diagnostic aid, the determination of root canal anatomy in teeth with complex canal configurations has become more precise. The present case report discusses successful nonsurgical management of radix entomolaris along with middle mesial canal and middle distal canal in mandibular first molar with seven canals (four canals in distal and three in mesial) employing CBCT as an adjunctive diagnostic aid to conventional radiography.

Keywords: Cone-beam computed tomography; mandibular first molar; seven root canals.

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Figures

Figure 1
Figure 1
(a) Preoperative radiograph of mandibular right first molar. (b) Working length radiograph with a file placed in each of the three mesial canals, three distal canals, and radix entomolaris. Arrow showing mid-distal canal. (c) Master cone placed in each of the seven root canals of mandibular right first molar. (d) Final obturation of the mandibular right first molar. Arrow showing mid-distal canal. (e) Postobturation radiograph (f) postobturation radiograph (distal angulation)
Figure 2
Figure 2
(a) Clinical view of the access cavity preparation showing seven distinct root canal orifices; mesiobuccal. mid-mesial, mesio-lingual, distobuccal, mid-distal, distoligual, and radix entomolaris. (b) Cone-beam computed tomography scan view at the coronal third showing four distinct root canals; distobuccal, mid-distal, disto-lingual and radix entomolaris. (c) Cone-beam computed tomography scan view at the middle third showing three distinct root canals; mesiobuccal, mid-mesial and mesiolingual
See this image and copyright information in PMC

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