ABSTRACT
The knowledge about the anatomic variation pulp cavity, specially in multi-rooted teeth, is an important factor for diagnosis and successful endodontic treatment. Root canal treatment of 4-rooted maxillary second molars has been described in only a limited number of case reports. The purpose of this case report was to illustrate and describe the endodontic treatment of a 4-rooted maxillary second molar. A 20-year-old female with no history of systemic disease was referred for treatment of her upper left second molar tooth. The diagnostic radiographies revealed root anomalies. After access cavity preparation, presence of four orifices in the pulp chamber was confirmed; each of them related to a distinct root. Root canal therapy was performed completely in all four roots. This case report indicates that the clinicians must be aware of anatomic variations during the diagnostic and treatment phases of maxillary molars, and proper root canal treatment should be performed respecting the presence of challenges in pulp space anatomy