Endodontic management of elusive middle mesial canal: Case report

Abstract

The middle mesial canal (MMC) in mandibular first molar presents a significant anatomical variation that can impact the success of endodontic treatment. Accurate identification and effective management of this canal is critical for achieving complete debridement and obturation. This review focuses on the challenges and strategies for managing the MMC during endodontic therapy. Advanced diagnostic tools such as cone-beam computed tomography (CBCT) and magnification aids, including dental operating microscope play a pivotal role in identifying and accessing the MMC. Techniques such as troughing with ultrasonic tips and modified access cavity designs enhance canal localization. Proper shaping and cleaning protocols are essential to address the anatomical complexity of MMC. The integration of advanced bioactive sealing materials like bioceramic sealer improves obturation outcome. This case report underscores the importance of a meticulous and evidence-based approach to managing the MMC in mandibular first molar to ensure long-term endodontic success