The accomplishment of a successful treatment outcome following endodontic therapy depends on a thorough chemo-mechanical preparation of the root canals followed by 3- dimensional obturation with a dense root canal inert filling material. An understanding of the presence of complex and unpredictable root canal morphology can positively affect the outcome of the therapy. Thus it is imperative that any aberrant root-canal configuration to be identified and treated accordingly. Therefore mandibular first molar with an intricate root canal anatomy can be clinically very challenging. This case report discusses endodontic treatment of mandibular first molar with seven root canals. This finding was confirmed using radiographs at different angulations and Dental CT scan during and after completion of the treatment.

Keywords: Mandibular first molar, Seven canals, Four distal canals, Dental CT scan, Extra canals.