Unusual root canal morphology of mandibular first premolar and its management: A rare case report

Endodontic management of aberrant canal morphology in mandibular premolar: A case series

A thorough assessment of complex canals in any tooth is a crucial prerequisite for the success of the treatment. The radicular space is often complex, and the canals might also additionally separate at all levels of the root canals, which poses a great challenge to the treating clinician. The mandibular premolars often have variations and complexity in the canal system. The abnormal morphology of these mandibular premolars makes it inaccessible to find and negotiate the additional canals; failure to identify other canals often leads to unsuccessful root canal treatment. This case series reports five successful nonsurgical root canal treatments in mandibular premolars.

Endodontic Management of Mandibular Second Premolar with Vertucci Root Canal Configuration Type V

The diversity of root canal anatomy in permanent dentition is quite common. Understanding the basic anatomy of the root canal morphology and its variations is particularly important for successful root canal treatment. Mandibular second premolar usually consists of a single root with a single root canal. The presence of split roots in the apical third of the root with two separate root canals is quite rare. The major cause of endodontic failure in missed canals is that it harbors bacteria and other microorganisms. Careful radiographic interpretation and clinical examination of the pulp chamber will be helpful in locating canal orifices. The mandibular premolars with Vertucci type V canal configuration pose a challenge in clinical management. Identifying them early is important to aid appropriate modification in treatment protocol. In this case report, important modifications of clinical steps and application of magnification for successful management with access chamber modification are explained.

Cone-beam computed tomography diagnosis and nonsurgical endodontic management of a taurodontic mandibular first premolar with two roots and four canals: A rare case report

Successful root canal treatment requires a thorough understanding of the normal root canal anatomy and possible variations for each tooth. Variations in the root canal anatomy are frequently associated with complex orientations of pulp tissues and complicating mechanical and chemical debridement. Inability to manage such complications may result in endodontic failure. Mandibular first premolars often exhibit a wide range of anatomic variations, complicating clinicians’ treatment. This clinical case report discusses the cone-beam computed tomography (CBCT) diagnosis and nonsurgical management of a taurodontic mandibular first premolar with two roots and four canals under a dental operating microscope (DOM). In endodontically challenging cases, using a DOM and CBCT imaging can help the clinician gain a better understanding of the complex root canal anatomy, allowing the clinician to more efficiently explore, clean, shape, and obturate the root canal system.

Mandibular first premolar with five root canals: a case report

Background

Understanding the anatomical morphology of the root canal is key for successful root canal treatment. The aims of this case presentation are to report a unique case of root canal treatment involving five root canals in the mandibular first premolar and to highlight the importance of variation in root canals of mandibular first premolars in clinical practice.

Case presentation

A 25-year-old male with intermittent pain in relation to the lower right posterior teeth over 3 weeks was diagnosed with symptomatic pulpitis in tooth #44. Four root canals were found, including mesiobuccal, distobuccal-1, distobuccal-2, and distolingual roots, and the Mtwo rotary system was used for root canal preparation. The four root canals were filled after 2 weeks, when a fifth canal was found, located in the buccal cavity. The fifth canal was confirmed to be the mesiolingual root canal by cone beam computed tomography (CBCT) and was found to be curved. After completion of the root canal filling, CBCT was performed, and a three-dimensional root canal image was reconstructed. After 1 week of observation, the tooth was repaired using composite resin filling.

Conclusions

This is the first case presentation of a fifth canal of the mandibular first premolar and advances our understanding of variations in the anatomy of the mandibular first premolar. This case report provides a reference for the treatment of mandibular first premolars.