Akademik Veri Yönetim Sistemi
MIDD 2025 – Mediterranean International Dental Days, Antalya, Türkiye, 6 - 08 Kasım 2025, sa.3, ss.22-23, (Özet Bildiri)
The root canal system of the maxillary first molar generally contains three canals: one palatal, one distobuccal, and one mesiobuccal root. However, the success of endodontic treatment depends on the clinician’s ability to correctly identify possible anatomical variations. Missed canals are considered one of the most important causes of long-term failures in root canal treatments. The aim of this case report is to present the diagnosis, treatment, and follow-up of a rare five-canal configuration detected in a maxillary first molar tooth that normally has three canals. A 27-year-old systemically healthy male patient presented to our clinic with a complaint of severe pain in tooth number 26. As a result of clinical and radiographic evaluation, the tooth was diagnosed with pulp necrosis and symptomatic apical periodontitis. For detailed examination of the root canal system, an evaluation was performed under an operating microscope, and five separate canal orifices (mesiobuccal 1, mesiobuccal 2, distobuccal 1, distobuccal 2, and palatal) were detected. All canals were shaped using rotary file systems, and an irrigation protocol with sodium hypochlorite and EDTA was applied. Calcium hydroxide was used as an intracanal medicament between sessions. The final root canal filling was completed using a combination of appropriate lateral and vertical condensation techniques. A five-canal root canal anatomy in maxillary first molar teeth is an extremely rare variation. This case emphasizes that clinicians should be careful regarding non-standard canal morphologies. The successful management of this five-canal variation demonstrates how crucial magnification provided by the operating microscope and three-dimensional imaging methods such as CBCT are in detecting canals that are likely to be missed. In conclusion, success in endodontic treatment is achieved through a complete understanding of root canal anatomy, effective cleaning and shaping of all canals, and their hermetic obturation.