Anatomic variations in root canal morphology have become easier to detect with the rapid advancements in clinical and diagnostic aids. Also an increased awareness of unusual anatomic morphology and a better understanding of the root canal system guides the clinician in diagnosis and treatment of such variations in order to achieve a successful endodontic outcome. Mesiobuccal root of first maxillary molar teeth have been considered to be one of the most complex and challenging root canal systems. This case report presents a successful management of a third canal in the mesiobuccal root of permanent maxillary first molar using dental operating microscope along with a modified access preparation and confirmed with the aid of spiral computed tomography.
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