Root canal treatment of dilacerated second maxillary premolars: Planning the shaping procedure

This article aims at investigating endodontic anatomical variants in the human maxillary premolars allowing the planning of safer and faster shaping procedures. Endodontic literature describes maxillary 2nd premolars as some of the easiest teeth to treat, as they have either one or two straight canals. Rarely they may sometimes have two dilacerated canals. This paper reports two clinical cases of maxillary premolars whose anatomy is quite unusual. In the first case report we describe a maxillary 2nd premolar with a single root and two dilacerated merged canals. The second case report concerns the retreatment of a maxillary 2nd premolar with a single root and two independent dilacerated canals, and even some lateral canal. In dilacerated anatomy, canal scouting step might cause some procedural errors. To avoid these procedural errors, we propose a modern step down technique using at first a rotary NiTi glide path instrument, to go up to the 2/3 of root canal length or until to the first impediment. This would allow an easy apical scouting of the last millimeters of endodont and increase the volume of the irrigants in the apical region. In this way since a safer and faster shaping procedure could be performed. Key words:Endodontic anatomy, maxillary 2nd premolar, modern step down technique.