Unraveling the Unexpected: Complex Root Canal Anatomy in a Mandibular Canine and Maxillary First Molar

Abstract Background Failure of endodontic treatment is frequently associated with missed canals due to complex root canal anatomy. A thorough understanding of root canal morphology and its variations is essential for successful outcomes. This article presents two rare cases highlighting unusual canal configurations in a maxillary first molar and a mandibular canine. Case presentation A 24-year-old male with irreversible pulpitis in a maxillary first molar exhibited five canals: two mesiobuccal canals (Vertucci Type II), two independent palatal canals (Type IV), and one distal canal. A 54-year-old patient with a mandibular canine showed two canals (buccal and lingual) merging in the apical third with two foramina. Both cases were managed using careful access modification, thorough canal exploration, working length determination with an apex locator, and cleaning and shaping with Hyflex CM rotary files. Irrigation protocols and obturation techniques were adapted to the complex anatomy. Conclusion These cases emphasize the importance of detailed radiographic evaluation, magnification, and sound knowledge of anatomical variations in detecting additional canals. Early identification and appropriate management of such complexities are crucial to prevent treatment failure and ensure long-term success in endodontic therapy.