Int J Dent Med Res | MAR- APR 2015 | VOL 1 | ISSUE 6 94 CASE REPORT Hindlekar A et al: Maxillary first molar with two mesiobuccal roots Correspondence to: Dr. Srinidhi Surya Raghavendra, Professor & Head, Department of Conservative Dentistry & Endodontics, Sinhgad Dental College & Hospital, 44/1, Vadgaon (Bk), Pune, Maharashtra, India. Maxillary First Molar with Two Mesiobuccal Roots: Report of a Rare Case Ajit Hindlekar 1 , Srinidhi Surya Raghavendra 2 , Nishant Vyavahare 3 , Niranjan Desai 4 A thorough knowledge of root canal morphology is a prerequisite for endodontic therapy. The main goal of endodontic treatment is healing of periapical tissues which are achieved by elimination of bacteria and their byproducts from the canal and prevention from reinfection. Anatomic forms and variations in teeth are well known, chief among them being extra roots/canals. The use of preoperative radiographs at different angles and advanced diagnostic aids like CBCT helps to detect and evaluate root canal morphology and anatomy. The maxillary first molar has been extensively studied with numerous case reports on variations through the years. There are reports of multiple canals, multiple roots and developmental abnormalities. This case report details the endodontic management of a maxillary first molar with four roots, Mesiobuccal1, Mesiobuccal2, Distobuccal and Palatal. KEYWORDS: Aberrant Canals, Maxillary First Molar, Mesiobuccal Root, Operating Microscope The main objective of root canal treatment is to relieve pain, disinfect the root canal and prevent reinfection. 1 Knowledge of root morphology and canal anatomy is essential for obtaining three dimensionally obturated root canal systems. Challenges faced during root canal treatment may be attributed to an inadequate understanding of the canal morphology of teeth, with undetected extra roots or root canals being the major reason for failure of root canal treatment. 2 Accurate radiographic technique with preoperative radiographs at different angles and proper interpretation are needed for sound diagnosis and treatment. Incidence of second mesiobuccal (MB2) canals in permanent maxillary first molars range from 18-96.1%. 3,4 Generally, it has three roots and four canals. The incidence of five canals is reported to be 2.25–2.4% 5 and the incidence of six canals is reported to be 0.319 – 0.88%. 6 The incidence of a second distobuccal (DB1) canal in the maxillary first molars is reported to be between 1.7 7 and 1.25%. 8 Baratto Filho et al 9 reported one maxillary first molar having three roots and seven canals out of 140 teeth. Raghavendra SS et al 10 and Kottoor et al 11 reported the endodontic management of maxillary first molars with seven and eight canals respectively. This paper describes a case of endodontic management of maxillary right first molar with four roots and five root canals. The aberrant root morphology was confirmed with the help of Cone Beam Computed Tomography (CBCT). There are two mesiobuccal roots (MB1 and MB2) with their own separate canals, one distobuccal and one palatal. The distobuccal and palatal roots had normal anatomy. To the best of our knowledge, this variation with two mesiobuccal roots has not been previously reported in the literature. A A A 27-year-old male patient reported to the Department of Conservative Dentistry and Endodontics with a complaint of continuous pain in an upper right posterior tooth since five days. The patient gave a history of intermittent pain on mastication in that tooth since past two months. On clinical examination, the maxillary right first molar had a mesio proximal carious lesion and was tender on percussion. Vitality testing of the involved tooth with heated gutta-percha gave a prolonged response while electric pulp testing (Parkell, USA) gave an early response. The pre operative radiograph (Fig No.1) showed mesio proximal caries involving the pulp space. The periodontal ligament space with respect to the mesiobuccal root was widened. From the history, clinical findings and radiographic interpretation, a diagnosis of symptomatic irreversible pulpitis with symptomatic apical periodontitis in maxillary right first molar was made. Non surgical endodontic therapy was recommended and patient’s consent was obtained. After local anesthesia, caries excavation was done and the mesial surface of the tooth was built up with composite How to cite this article: Hindlekar A, Raghavendra SS, Vyavahare N, Desai N. Maxillary First Molar with Two Mesiobuccal Roots: Report of a Rare Case. Int J Dent Med Res 2015;1(6):94-97. INTRODUCTION 1- Post graduate student, Department of Conservative Dentistry & Endodontics, Sinhgad Dental College & Hospital, Pune. 2- Professor & Head, Department of Conservative Dentistry & Endodontics, Sinhgad Dental College & Hospital, Pune. 3- Lecturer, Department of Conservative Dentistry & Endodontics, Sinhgad Dental College & Hospital, Pune. 4- Reader, Department of Conservative Dentistry & Endodontics, Sinhgad Dental College & Hospital, Pune. ABSTRACT CASE REPORT