case_images: PMC10840594_01
case_images: Preoperative intraoral periapical radiograph of the mandibular right first molar tooth
case_images: cureus-0016-00000051746-i01.jpg
case_images: PMC10840594_01_cureus-0016-00000051746-i01.jpg
case_images: FIG1
case_images: Priorly, a diagnostic intraoral periapical radiograph demonstrated the extension of caries up to the level of the involvement of the pulp, which needed an endodontic intervention to be performed (Figure 1).
case_images: Access opening with the mandibular right first molar with the red arrow indicating the presence of the mid-mesial canal
case_images: cureus-0016-00000051746-i02.jpg
case_images: PMC10840594_01_cureus-0016-00000051746-i02.jpg
case_images: FIG2
case_images: Using ultrasonic tips of size Start-X #1 and Start-X #3 (Start-X, Dentsply Sirona), exploration of mid-mesial orifice openings was done and processed with a 10K file (Figure 2).
case_images: Working length determination in the mandibular molar measured using a 10 Kerr file (Mani, Japan)
case_images: cureus-0016-00000051746-i03.jpg
case_images: PMC10840594_01_cureus-0016-00000051746-i03.jpg
case_images: FIG3
case_images: Determination of working length was done using J Morita Root Zx Mini Apex Locator (Japan) (Figure 3).
case_images: Mastercone fit assessment done with gutta-percha cones of size 6% taper (Dentsply Sirona) in the mandibular molar
case_images: cureus-0016-00000051746-i04.jpg
case_images: PMC10840594_01_cureus-0016-00000051746-i04.jpg
case_images: FIG4
case_images: The root canal was dried with the help of paper points and obturated with 6% gutta-percha cones (Dentsply Sirona) using the technique of warm vertical compaction along with epoxy resin sealer (AH Plus sealant, Dentsply Sirona) (Figure 4).
case_images: Obturation and post-endodontic restoration with composite resin
case_images: cureus-0016-00000051746-i05.jpg
case_images: PMC10840594_01_cureus-0016-00000051746-i05.jpg
case_images: FIG5
case_images: Paul, MN) (Figure 5).
case_images: PMC10840594_02
case_images: Preoperative intraoral periapical radiograph of the mandibular right first molar tooth
case_images: cureus-0016-00000051746-i06.jpg
case_images: PMC10840594_02_cureus-0016-00000051746-i06.jpg
case_images: FIG6
case_images: Caries excavation was done following prior radiographic assessment, upon which extension of the carious pathology was seen invading the pulp in the right mandibular first molar number 46 (Figure 6).
case_images: Access opening with the mandibular right first molar indicating the mid-mesial canal
case_images: cureus-0016-00000051746-i07.jpg
case_images: PMC10840594_02_cureus-0016-00000051746-i07.jpg
case_images: FIG7
case_images: Negotiation of four different orifices was done: three mesially (mesiobuccal, mid-mesial canal, and mesiolingual) and a distal canal (Figure 7 and Figure 8).
case_images: Working length determination in the mandibular molar measured using a 10 Kerr file (Mani, Japan)
case_images: cureus-0016-00000051746-i08.jpg
case_images: PMC10840594_02_cureus-0016-00000051746-i08.jpg
case_images: FIG8
case_images: Negotiation of four different orifices was done: three mesially (mesiobuccal, mid-mesial canal, and mesiolingual) and a distal canal (Figure 7 and Figure 8).
case_images: Mastercone fit assessment done using gutta-percha cones in the mandibular molar
case_images: cureus-0016-00000051746-i09.jpg
case_images: PMC10840594_02_cureus-0016-00000051746-i09.jpg
case_images: FIG9
case_images: Post-obturation radiography revealed that the mid-mesial canal was independent of the mesiolingual canal extending from the coronal to the apical area (Figure 9).
case_images: Obturation and post-endodontic restoration with resin composite
case_images: cureus-0016-00000051746-i10.jpg
case_images: PMC10840594_02_cureus-0016-00000051746-i10.jpg
case_images: FIG10