Endodontic treatment of a molar-incisor malformation of the maxillary first molar: a case report

Molar-incisor malformation (MIM) is a developmental dental anomaly primarily affecting permanent first molars, often accompanied by structural irregularities such as cervical mineralized diaphragms (CMDs) and furcal channels. These anatomical complexities present significant challenges for endodontic treatment. This case report presents the endodontic management of a maxillary first molar diagnosed with MIM-a condition for which root canal treatment has rarely been reported. The affected tooth exhibited characteristic features of MIM, including underdeveloped roots, CMD, and an open furcal channel. Initial canal negotiation revealed four buccal canals, but the palatal canal could not be located via conventional access. A separate access approach enabled successful identification, disinfection, and obturation of the palatal canal. Follow-up imaging showed healing of the periapical lesion and favorable clinical outcomes. This case highlights the diagnostic and technical challenges in managing MIM-affected teeth and underscores the importance of advanced imaging, tailored access strategies, and careful material selection to achieve successful endodontic outcomes.