Detection and management of a complex canal configuration in mesiobuccal root of maxillary first molar using three dimensional imaging

This case report discusses the identification and management of complex canal configuration of 3-2-1 in the mesiobuccal (MB) root of the maxillary left first molar. Careful attention to details of the pulpal floor and applying the knowledge of the laws of orifice location along with deepening the subpulpal groove with ultrasonic tips helped in identifying the three MB canals. Manual scouting helped in understanding the anatomic configuration; the use of three-dimensional imaging technique and spiral computed tomography (SCT) confirmed the same. SCT images showed buccolingually wide and bulbous mesiobuccal root with three separate canals at coronal third that merged into two canals in the middle and exited as a single canal at the apex. This article highlights the role of SCT in three-dimensionally analyzing the unseen rarest canal configurations that ultimately enabled the clinician to thoroughly explore, debride, and obturate the entire root canal system.