Abstract: The root canal system of maxillary second molars often exhibits variations, typically presenting with three roots and three canals. The occurrence of dual palatal roots is relatively rare. This article reports a case of bilateral maxillary second molars with dual palatal roots and describes the microscopic root canal treatment performed on the left maxillary second molar. This case highlights the complexity of root canal variations in maxillary second molars, reminding clinicians to conduct a comprehensive preoperative assessment of their root canal anatomy. When necessary, cone-beam computed tomography (CBCT) and dental operating microscopy (DOM) could be employed to determine the position, number, and configuration of the root canals, thereby improving the success rate of root canal treatment.

Key words: maxillary second molar, dual palatal roots, root canal variations, cone beam computed tomography, dental operating microscopy