Endodontic management of a hidden middle distal canal in mandibular first molar with post-operative CBCT-a case report

The main objective of root canal treatment is thorough mechanical and chemical cleansing of the entire pulp space and to provide an intact hermatic seal. A 30 year-old female patient was referred to the Department of Conservative Dentistry and Endodontic with a chief complaint of acute pain in her right lower back tooth. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpits with symptomatic apical periodontitis was made for tooth 46, and root canal treatment was scheduled. Access cavity, radiographs revealed 5 canals: mesiobuccal, mesiolingual, distobuccal, middle distal, distolingual. Obutartion was done with warm vertical compaction technique using AH-Plus sealer. To be able to precisely detect, search, and decontaminate root canal system, cone-beam computed tomography can be used to aid in diagnosis of root canal morphology. Treating extra canals may be challenging but the inefficiency to find and properly treat root canals may cause failures.