Navigating Trifurcated Root Anatomy in Maxillary Premolars: A Detailed Endodontic Case Series

A foundational grasp of root canal anatomy is vital for achieving predictable treatment and long-term outcomes in endodontics. Untreated canal is the primary cause of persistent apical periodontitis following endodontic therapy. Maxillary premolars with three roots and canals exhibit a rare but clinically significant anatomical variation characterized by a trifurcation on the root. This feature is frequently overlooked and can contribute to endodontic failure if not properly diagnosed and managed. Recognition of such anatomical variations, combined with the use of radiographic imaging, magnification, and ultrasonics is essential for clinicians to ensure predictable and effective endodontic treatment outcomes. Integration of cone-beam computed tomography (CBCT) in endodontics significantly enhances the diagnostic precision and accuracy in identifying such complex anatomies. This case series highlights the strategies in endodontic management of maxillary premolars with trifurcation.