Cone Beam Computed Tomography-aided Endodontic Management of Second Maxillary Molar with Two Separate Palatal Roots: A Case Report

An infected human root canal system harbors harmful microbiota that needs to be eliminated by root canal therapy. But the human root canal system is known to have a complex anatomy. Hence, the knowledge of a possibly aberrant anatomy is deemed necessary before carrying out a root canal therapy. Usually, the maxillary second molars have three roots and three or four root canals (a second mesiobuccal canal as the fourth canal). The presence of a second palatal root and a second palatal root canal is very rare (1.4% incidence). Failure to locate and treat such aberrant external and internal anatomy results in a compromised root canal therapy. With the introduction of advanced imaging and visualization techniques such as cone beam computed tomography (CBCT) and dental operating microscopes, the variations in root anatomy have been successfully detected and treated. This case report describes the endodontic management of a second maxillary molar with two palatal roots and four separate canals, performed with the help of CBCT.