Mandibular first molar with six separate canals

Introduction: Many anatomical variations can occur within the mandibular first molar. Commonly, 3-4 canals are located, but as many as 6-7 canals have been reported. Methods: This report describes a case of a mandibular first molar with 6 separate canals (3 mesial and 3 distal) that was instrumented with conventional hand and rotary files and obturated by using a hybrid warm vertical compaction technique. Results: Recall examination as far as 3 years post-treatment found no sensitivity to percussion or palpation and recall radiographs after treatment show resolution of the previous apical periodontitis. Conclusions: The existence of such teeth as these underlies the importance of looking for additional canals.