Endodontic management of the mandibular first molar having independent middle mesial canal and radix entomolaris within the same tooth

Abstract

The aim of this case report is to present the clinical management of mandibular first molar with three separate mesial canals including independent middle mesial canal and an extra distal root; radix entomolaris (RE). The left mandibular first molar of a male patient was a root canal treated. Mesiobuccal and mesiolingual canals were found in their normal locations. Third canal; the middle mesial canal was identified after a thorough examination of the pulpal floor under the operating microscope. Radiographically, it ended in its own distinct foramen. In addition, an extra distal root; RE was also present. Therefore, five canals (mesiobuccal, middle mesial, mesiolingual, distobuccal and distolingual) were identified, instrumented and obturated to the accepted lengths. Many reports deal with three orifices in the mesial root, but very few describe three independent canals and RE within the same tooth, indicating a rare anatomical configuration.

Keywords

• mandibular first molar
• middle mesial canal
• root canal treatment