Endodontic Management of An Unusual Mandibular First Molar with Six Canals: A Case Report and Systematic Review

The permanent mandibular first molar is frequently involved in conventional root canal treatment due to its function and position the oral cavity. Additional canals mandate accurate diagnosis conservative management prevent any procedural errors. independent middle mesial incidence was verified molars 1974, with a global of 10.8–27.0%. Reporting distal endodontic literature scarce, an 0.2–3%. present case report describes unusual three roots, diagnosed irreversible pulpitis apical periodontitis. A dental operating microscope multiple angulated radiographs were used identify morphology, this confirmed cone-beam computed tomography imaging. access cavity modified trapezoidal shape, pulp chamber carefully explored following dentinal maps expose additional by ultrasonic troughing. Incorporating imaging routine cases facilitates better understanding visualization complex anatomy, making even endodontically challenging more predictable.