This case is worth noting simply because it is rare to have a molar with more than 4 canals, especially mandibular second molar! My initial search of endodontic literature produced many reports of mostly mandibular first molars with five canals, three mesial canals, three distal canals, and one recent report by Ryan JL of a first mandibular molar with six separate canals.
37 year old white female presented to me today with symptoms of pulpitis associated with tooth #31. A referral was made by her general dentist after carious exposure.
In this case, pre-op x-ray did not reveal anything unusual, although an angulated view may have been helpful.
Pre-op
During treatment, I always look for additional canals using the microscope. But often, one can suspect “extra” canals by carefully evaluating the position and relationship of canal orifi to the outer tooth surface at the level of CEJ and to each other. Upon access, I immediately located four canals, but noticed that MB and ML are way apart from each other. Upon trophing between MB and ML canals using ultrasonic and scope, a mid mesial was located. Same was done on the distal.
Six canals
Post-op
Post-op angulated
