02 September 2026
: Case report 
Management of a Rare 4-Rooted Maxillary First Molar With 5 Canals and an Endo-Periodontal Lesion: A Case Report
Unusual or unexpected effect of treatment
Yifan Wang ACDEF 1, Hong Jiang ABF 2, Yanhong Hao AB 2, Zhen Fang BC 3, Shige Liu B 2, Jie Pan ACD 4, Huan Jing ABCDG 2*DOI: 10.12659/AJCR.953554
Am J Case Rep 2026; 27:e953554
Table 1 Before-and-after comparison of clinical and imaging indicators.
| Category | Indicator | Pre-treatment baseline | Post-treatment (8-month follow-up) |
|---|---|---|---|
| Pain on chewing, intermittent discomfort | Asymptomatic | ||
| Grade III | Grade I | ||
| 6–8 mm (localized palatal) | 3–5 mm | ||
| Tender to percussion (+) | Normal (−) | ||
| Extensive periapical radiolucency & severe horizontal bone loss | Marked reduction in radiolucency; signs of osseous regeneration | ||
| Mucosal thickening contiguous with apical lesion | Significant reduction and marked improvement of mucosal thickening |