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Case Reports
. 2020 Sep 10;20(1):253.
doi: 10.1186/s12903-020-01241-0.

Mandibular first premolar with five root canals: a case report

Ming Zhang  1 , Jian Xie  2 , Yan-Huang Wang  1 , Yan Feng  3
Affiliations
Case Reports

Mandibular first premolar with five root canals: a case report

Ming Zhang et al. BMC Oral Health. .

Abstract

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.

Keywords: Anatomic variation; Case report; Dental operating microscope; Endodontic treatment; Root canal system.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Preapical radiographs of tooth #44. a The lower third of the root canal of the first right premolar had branches; b Working length radiographs of four root canals of the tooth were measured; c Four root canals were filled; d The missing mesiobuccal root canal was found and measured; e Radiograph showing obturation of all five canals; f Recall observation X-ray 6 months later; g Recall observation X-ray 48 months later
Fig. 2
Fig. 2
Orifices of the five root canals of tooth #44 with obturation under the microscope. Mesiobuccal canal (MB), distobuccal 1 canal (DB), distobuccal 2 canal (DB2), mesiodistal (ML), and distolingual (DL)
Fig. 3
Fig. 3
3D reconstruction of the root canal of tooth #44 after filling. a-d 3D reconstruction of teeth from different angles; gray is the tooth tissue, and red is the root canal tissue. e A cross section of the root canal at the apical area
See this image and copyright information in PMC

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