INTRODUCTION:
Knowledge of internal dental morphology is an extremely important in planning and administering endodontic therapy.The numerous anatomical variations existing in root canal system may contribute to the failure of root canal therapy. Failure to explore and instrument even one of the canals results in improper cleaning of root canal system and can lead to endodontic treatment failure. The mandibular first molar, the earliest permanent posterior tooth to be erupt, seems to be the tooth that most often requires root canal treatment. The usual canal distribution is two canals in the mesial root and one or two canals in the distal root.
A 38 year-old female patient presented with a chief complaint of pain in the mandibular left posterior tooth for the past two weeks. Clinical examination revealed a carious left mandibular first molar (36). The clinical and radiographic findings led to a diagnosis of acute exaggeration of chronic periapical abscess.
Down below are the images and radiographs of given treatment.
Figure above shows Pre operative radiograph of the mandibular left first molar tooth showing the presence of more than one canal in distal root, in the patient in the case report
All canals were identified and working length was established by using apex locators and IOPAs
Below is the post operative x ray in which mesial orifices had an additional orifice between the two main buccal and lingual canals and distal orifices showing an additional orifice between two main buccal and lingual canals
Complete obturation was done with full ceramic crown and on recall after 2 months patient had no pain or any sign of infection.
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