Endodontic treatment of a double-rooted maxillary second molar with four canals: a case report.

A healthy female was referred to Endodontic Department. The referral letter from her dentist expressed that an emergency pulpotomy of tooth #27 had been carried out with probable perforation of the chamber floor which was due to the unusual anatomy of the chamber. Cone-beam computed tomography (CBCT) revealed that the tooth had two mesial and two distal canals. Perforation site was repaired and endodontic treatment was completed. At 24-month follow-up, patient was asymptomatic and clinical and radiographic examinations showed successful outcomes.

Healing of an extensive periradicular lesion subsequent to a proper endodontic treatment of a mandibular first premolar with complex anatomy.

Long-term success of endodontic treatment is strictly dependent on proper shaping and cleaning of the root canal system followed by obturation of entire prepared space. Anatomical variations should be considered during radiographic and clinical evaluation as parts of endodontic treatment. A mandibular premolar with three canals is quite rare and such a tooth requires special canal preparation and obturation techniques. An astute clinician should identify different canal configurations and treat them endodontically well, because presence of an untreated canal could be a reason for failure of endodontic treatment. This paper describes the conventional orthograde endodontic therapy on an unusual mandibular first premolar with three root canals.