Patient Presentation

  • The patient reported with pain in the upper left back tooth region.
  • Clinical exam showed a large carious lesion in tooth 26.
  • Radiograph revealed a radiolucency approaching the pulp.

Diagnosis

Based on clinical symptoms and radiographic findings:

  • Symptomatic Irreversible Pulpitis irt 26.

Treatment Plan

  • Planned for Root Canal Treatment (RCT) to relieve pain and save the tooth.

Treatment Procedure

  • Local anaesthesia is administered for painless treatment.
  • Access cavity prepared under magnification.
  • All three main canals are located – MB, DB, and Palatal.
  • An additional canal (MB2) was also carefully located and negotiated.
  • Complete biomechanical preparation and irrigation of all canals, including MB2.
  • Obturation was done using warm vertical compaction for a dense and sealed fill.
  • Temporary restoration placed; final crown advised.

Outcome

  • The patient experienced immediate relief from pain post-treatment.
  • Successful identification and treatment of the MB2 canal enhanced prognosis.
  • Final restoration is planned to restore full function and aesthetics.

Clinical Insight

  • MB2 canal is commonly missed in upper first molars.
  • Use of proper magnification and technique is crucial for endodontic success.
  • Treating all canals, especially additional ones like MB2, helps prevent failure

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