Endodontic retreatment of a maxillary first molar with two palatal roots and three palatal canals

Introduction Variations in the root and canal morphology are a common occurrence. The clinician should have a thorough knowledge of dental anatomy and its variations in order to achieve successful and predictable outcome with root canal treatment. Maxillary first permanent molars are generally considered to be three rooted, one palatal and two buccal. The additional root canal, if present, is typically located in the mesiobuccal root. The frequency of two palatal roots is low (0.4%-1.4%) and only a few cases have been reported in the literature. The extra palatal root is a supernumerary structure which can be located either mesiolingually or distolingually. Accordingly, they are designated as Radix Mesiolingualis and Radix Distolingualis respectively, based on their relation with the crown of the tooth. Stone and Stroner reported variations of the palatal root of maxillary molars, such as a single root with two separate orifices, two Abstract Aim: To report an unusual anatomy of permanent maxillary first molar. Summary: Variations in the dental anatomy are common. A thorough knowledge of these anatomic variations is critical to the success of the endodontic treatment. This article reports a clinical case of a maxillary first molar requiring endodontic re-treatment that had two palatal roots and three palatal canals. This case represents an uncommon anatomical condition and stresses upon the importance of exploring for the presence of extra roots and canals. Key learning points: • Clinician should be aware of anatomical variations in maxillary molars. • Maxillary molars may have supplementary palatal roots as well as additional root canals.