Endodontic management of a maxillary first molar with unusual location of second mesio buccal orifice

Maxillary first molar can have a mesio-buccal-2 (MB2) orifice located palatally, but adjacent to the mesio buccal orifice. An awareness and understanding of this root canal morphology can contribute to the successful outcome of root canal treatment. This report discusses endodontic treatment of a maxillary first molar with unusual location of second mesio buccal orifice. Conventional diagnostic aids such as radiographs play an important role in assessment of complex root canal morphologies. These modalities, however, do not provide detailed information of the complexity as a result of their inherent limitations. This article discusses the variations in the orifice location and the use of latest adjuncts in successfully diagnosing and negotiating them.