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Natural Sciences, Stomotology, 2026

ENDODONTIC MANAGEMENT OF PERMANENT MANDIBULAR FIRST MOLAR WITH FOUR DISTAL ROOT CANALS: A CASE REPORT

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Submitted: 2026-04-08
CC BY-NC 4.0 This work is licensed under Creative Commons Attribution–NonCommercial International License (CC BY-NC 4.0).

Abstract

Endodontic therapy of mandibular molars is complicated due to the varied configuration of roots and canals. There
are numerous cases in the literature describing the distinctive anatomy of mandibular first molars. An interesting
illustration of anatomical variance in a mandibular first molar with more than four canals, particularly when four of
these canals are found in distal roots. A mandibular first molar with six canals—two mesial and four distal canals in
two distal roots—is the main focus of this report. A thorough grasp of anatomical variances, preoperative awareness,
and intraoperative attention to detect both typical and distinctive anatomy of the root canal system can help to raise
the rate of therapeutic success.

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