A Maxillary Second Premolar with Four Canals: A Case Report

Abstract

Profound knowledge of the internal anatomy and configuration of the teeth plays a pivotal role in the success of standard root canal treatment. The presence of unexpected extra root canals has been reported in all the teeth, making root canal treatment a challenge for every clinician. Although the maxillary second premolar is no exception to this rule, the presence of a variety of multiple canals is relatively rare. In fact, the presence of three separate root canals has been reported in only 1-6% of cases. A 33-year-old male was referred for root canal retreatment of his left maxillary second premolar. An intraoral periapical radiograph revealed previous substandard endodontic treatment. Retreatment was performed under an operating microscope, and four root canals were found, which is, in fact, very rare. This case highlights another variation in the morphology of such teeth and it does highlight the importance of using magnification, especially an operating microscope in endodontic treatment.

Keywords: Anatomical Variations; Dental Operating Microscope; Maxillary Second Premolar.

Figure 1

A) Preoperative radiograph shows the presence of a temporary restoration and underprepared and poorly obturated root canals with early signs of loss of lamina dura; B) The final radiograph shows the obturated root canals; C) The follow-up radiograph after 12 months shows healthy periapical tissues; D) Prepared canals before obturation; E, F) Four canals before obturation after sealer placement in the canals can be seen vividly; G) Obturation of the 4 canals was done