A Short Case Study: A Maxillary First Molar with Two Palatal
This started out to be a normal case. Upon access there was a lot of bleeding on the pulpal floor. I used a slow round to smooth out the pulpal floor under the microscope. I was able to see a total of 5 canals and treat them.

To investigate properly the possibility of additional canals, the dentist should:

> Take additional off-angle radiographs or CBCT;
> Ensure adequate “straight-line” access to improve visibility and make sure the canal is centered in the root;
> Examine the pulpal floor for “lines” to areas where additional canals may be located;
> Remove a small amount of tooth structure or the dentinal shelf, which often may occlude a canal orifice.

The frequency of a maxillary first molar with two palatal canals is very low, about 1%. I may not ever see another one in my lifetime....

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