Case report/clinical technique| Volume 33, ISSUE 12, P1481-1483, December 2007

Mandibular First Molar with Four Distal Canals

Published:October 16, 2007DOI:


      A mandibular first molar with more than four canals is an interesting example of anatomic variations, especially when four of these canals are located in distal roots. This report describes a case of a mandibular first molar with six canals (two mesial and four distal canals in two distal roots). The canals were equipped with a K-file and irrigated with NaOCl (5.25%) and normal saline as the final irrigant. The canals were filled laterally with gutta percha and AH26 sealer (De Trey, Dentsply, Switzerland). This case shows a rare anatomic configuration and points out the importance of looking for additional canals.

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        • Cohen S.
        • Hargreaves K.M.
        Pathways of the pulp.
        in: 9th ed. Mosby, St Louis2005: 220
        • Vertucci F.J.
        Root canal anatomy of the human permanent teeth.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1984; 58: 589-599
        • Pineda F.
        • Kuttler Y.
        Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1972; 33: 101-110
        • Zaatar E.I.
        • al Anizi S.A.
        • al Duwairi Y.
        A study of the dental pulp cavity of mandibular first permanent molars in the Kuwait population.
        J Endod. 1998; 24: 125-127
        • Reeh E.S.
        Seven canals in a lower first molar.
        J Endod. 1998; 24: 497-499
        • Jacobsen E.L.
        • Dick K.
        • Bodell R.
        Mandibular first molars with multiple mesial canals.
        J Endod. 1994; 20: 610-613
        • Skidmore A.E.
        • Bjorndal A.M.
        Root canal morphology of the human mandibular first molar.
        Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1971; 32: 778-784
        • Wasti F.
        • Shearer A.C.
        • Wilson N.H.
        Root canal systems of the mandibular and maxillary first permanent molar teeth of South Asian Pakistanis.
        Int Endod J. 2001; 34: 263-266
        • De Moor R.J.
        • Deroose C.A.
        • Calberson F.L.
        The radix entomolaris in mandibular first molar: an endodontic challenge.
        Int Endod J. 2004; 37: 789-799
        • Calberson F.L.
        • De Moor R.J.
        • Deroose C.A.
        The radix entomolaris and paramolaris: clinical approach in endodontics.
        J Endod. 2007; 33: 58-63
        • Yew S.C.
        • Chan K.
        A retrospective study of endodontically treated mandibular first molars in a Chinese population.
        J Endod. 1993; 19: 471-473
        • Steelman R.
        Incidence of an accessory distal root on mandibular first permanent molars in Hispanic children.
        ASDC J Dent Child. 1986; 53: 122-123
        • Sperber G.H.
        • Moreau J.L.
        Study of the number of roots and canals in Senegalese first permanent mandibular molars.
        Int Endod J. 1998; 31: 117-122
        • Curzon M.E.
        Three rooted mandibular permanent molars in English Caucasian.
        J Dent Res. 1973; 52: 181-183
        • Tratman E.K.
        Three rooted lower molars in man and their racial distribution.
        Br Dent J. 1938; 64: 264-274
        • Walker R.T.
        • Quackenbush L.E.
        Three rooted lower first permanent molars in Hong Kong Chinase.
        Br Dent J. 1985; 159: 298-299