Endodontic Treatment of Maxillary 1st molar with 4 canals

After locating all 4 canals on tooth #14 (MB1, MB2, DB, P), working length was established, and cleaning and shaping of all canals performed under copious irrigation with sodium hypochlorite. Final irrigation w/ EDTA. All 4 canals were obturated using warm vertical gutta percha technique. Access sealed with cotton pellet and glass ionomer. Occlusion checked, post-operatory instructions given and patient referred back to General Dentist for final restoration of the tooth with build up and crown.

Locating the 4th canal in Maxillary First Molars

The incidence of second mesiobuccal canal has been reported to range between 40 and 95%.
In the picture above we see 4 root canal orifices located after the access opening on tooth #14: MB1, MB2, DB and P.
The use of microscopes greatly increased the location and treatment of the second mesiobuccal canals of maxillary first molars.