Bilateral Occurrence of Mandibular Permanent Second Molar With Four Roots: A Case Report and Literature Review

Basic knowledge of tooth anatomy is essential for endodontic success. The most common configuration of the mandibular second molar is the presence of two roots. However, single-, three-, four-, and even five-rooted forms have also been reported in the literature. The purpose of this study is to present a clinical case of a mandibular second molar with four roots. Morphology was assessed using CBCT examination, which revealed that the patient has bilateral four-rooted second lower molars-an anomaly that, to our knowledge, is extremely rare in the literature. Awareness and careful diagnosis of such anomalies are crucial to ensure all canals are treated, improving clinical outcomes and preventing treatment failure.