ENDODONTIC MANAGEMENT OF A MANDIBULAR PRIMARY FIRST MOLAR WITH FIVE CANALS UNDER DENTAL OPERATING MICROSCOPE: A RARE ANATOMIC VARIATION
Keywords:
Morphological variations, Primary molars, Pulpectomy, Extra Canals, Endodontic microscope, Case reportAbstract
The root canal morphology of primary molars is highly variable, with most mandibular primary first molars typically presenting with three or four canals. The presence of an additional canal is rare and poses a challenge in endodontic treatment. Identifying and managing such anatomical variations is critical to ensure complete debridement, disinfection, and obturation of the root canal system, ultimately leading to successful treatment outcomes. This case report describes the endodontic management of a mandibular primary first molar with an unusual morphology of five canals in a 6-year-old patient. The patient presented with symptoms indicative of pulpal involvement, and clinical and radiographic examinations were performed. Intraoral periapical radiographs, along with careful exploration of the pulp chamber, confirmed the presence of an additional canal in the mesial root, resulting in a total of five canals, which was done under an endodontic microscope. A thorough understanding of root canal variations in primary molars is crucial for successful endodontic treatment. This case highlights the significance of detailed radiographic assessment, careful exploration, and precise canal preparation in managing complex root canal anatomy. Early diagnosis and appropriate treatment of such cases are essential for preserving primary dentition, which plays a vital role in occlusal development and space maintenance for the eruption of permanent teeth.
References
1. Salama FS, Anderson RW, McKnight-Hanes C, Barenie JT, Myers DR. Anatomy of primary incisor and molar root canals. Pediatr Dent 1992;14(2):117–8.
2. Sarkar S, Rao AP. Number of root canals, their shape, configuration, accessory root canals in radicular pulp morphology. A preliminary study. J Indian Soc Pedod Prev Dent 2002;20(3):93–7.
3. Malavika K, Samuel V, Ramar K. Root Canal Morphology of Primary Mandibular First Molar: A Systematic Review. J Clin Diagn Res [Internet]. 2023 [cited 2025 Mar 18]; Available from: https://www.jcdr.net//article_fulltext.asp?issn=0973-709x&year=2023&month=March&volume=17&issue=3&page=ZE14-ZE18&id=17607
4. Manoj Kumar MG. Pyramidal molar roots in primary and permanent dentition along with non syndromic oligodontia in a 11 year old boy. Ann Essences Dent 2010;2(2):36–9.
5. Aminabadi NA, Farahani RMZ, Gajan EB. Study of root canal accessibility in human primary molars. J Oral Sci 2008;50(1):69–74.
6. Bagherian A, Kalhori KAM, Sadeghi M, Mirhosseini F, Parisay I. An in vitro study of root and canal morphology of human deciduous molars in an Iranian population. J Oral Sci 2010;52(3):397–403.
7. Mesbahi M, Talei S, Mollaverdi F, Kadkhodaza M. Comparision of Root Canal System Configuration in Primery Teeth. Res J Biol Sci 2010;5(7):488–91.
8. Gupta D, Grewal N. Root canal configuration of deciduous mandibular first molars--an in vitro study. J Indian Soc Pedod Prev Dent 2005;23(3):134–7.
9. Rana V, Shafi S, Gambhir N, Rehani U. Deciduous Mandibular Second Molar with Supernumerary Roots and Root Canals Associated with Missing Mandibular Permanent Premolar. Int J Clin Pediatr Dent 2011;4(2):167–9.
10. Zoremchhingi, Joseph T, Varma B, Mungara J. A study of root canal morphology of human primary molars using computerised tomography: an in vitro study. J Indian Soc Pedod Prev Dent 2005;23(1):7–12.
11. Sim D, Mah Y. A Study of Root Canals Morphology in Primary Molars using Computerized Tomography. J Korean Acad Pedtatr Dent 2019;46(4):400–8.
12. Wang YL, Chang HH, Kuo CI, Chen SK, Guo MK, Huang GF, et al. A study on the root canal morphology of primary molars by high-resolution computed tomography. J Dent Sci 2013;8(3):321–7.
13. Ozcan G, Sekerci AE, Cantekin K, Aydinbelge M, Dogan S. Evaluation of root canal morphology of human primary molars by using CBCT and comprehensive review of the literature. Acta Odontol Scand 2016;74(4):250–8.
14. Ahmed HMA, Dummer PMH. Advantages and Applications of a New System for Classifying Roots and Canal Systems in Research and Clinical Practice. Eur Endod J 2018;3(1):9–17.
15. Kumar G, Rehman F. Comparative Evaluation of Clinical and Radiographic Success of Pulpectomy Done with and without Dental Operating Microscope in Pediatric Patients: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(Suppl 2):155–60.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Sakshi Shah, Gauri Kalra, Tanu Nangia, Madhulika Srivastava, Rashika Singhania
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
