INTRODUCTION
The maxillary first molar is one of the most commonly treated teeth in
endodontic due to its complex anatomy, which has intrigued clinicians
for a long time. The primary goal of endodontic therapy is the accurate
identification, thorough cleaning and shaping, and three-dimensional
obturation of the entire root canal system.(1) Failure to detect
additional roots or canals can lead to endodontic treatment failure.(2)
Typically, maxillary molars are described as having three roots and
three canals, with one canal in each root. However, studies have shown
considerable variation in the number and configuration of root canals in
these teeth. The occurrence of a third canal in the mesiobuccal root
(MB3) of the maxillary first molar is rare, with a reported incidence
ranging from 1.1% to 1.6%.(3,4) Similarly, the presence of a second
canal in the distobuccal root (DB2) has been reported in 1.7% of
cases.(5)
This clinical report presents a rare case of a maxillary first molar
with six root canals. Successful identification and treatment of all
root canals in this patient were confirmed through the use of 20-degree
horizontally angulated radiographs, aided by magnification with loupes.