Endodontic management of maxillary first molar with unusual anatomy

This article reports nonsurgical endodontic management of bilateral maxillary first molars with an unusual morphology of a single root and a Sert and Bayirli type-IX canal configuration. A 41-year-old female reported with dull continuous pain in the maxillary left and right quadrants. On clinical examination, the maxillary first molars on both sides were carious with pulpal exposure and radiographic evaluation revealed an unusual anatomy of single root and single canal for both of them. Based on clinical and radiographic examination, tooth numbers 16 and 26 were diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. Root canal treatment was initiated and cone-beam computed tomography (CBCT) imaging was advised on encountering unusual internal anatomy. The CBCT images revealed the presence single root and a Sert and Bayirli type-IX canal configuration bilaterally. Root canal treatment was performed under magnification using the dental operating microscope.