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Endodontic Retreatment of a Mandibular First Premolar With Unusual Four Root Canal Morphology: A Case Report
Hsin Lan1, Yi Chen Chiang1, Chin Sung Chen1,2,3
1Department of Endodontics Sijhih Cathay General Hospital New Taipei Taiwan cgh.org.tw.
Introduction:
Mandibular premolars exhibit complex root canal systems, making them highly challenging to manage endodontically. Canal configurations vary from one to five canals. Successful endodontic treatment requires a thorough knowledge of standard anatomy and its variations.
Case Presentation:
This case report presents the endodontic retreatment of a right mandibular first premolar with four separate root canals in a 36-year-old male. Initial clinical and radiographic examinations showed a complex root canal anatomy. With the aid of a dental operating microscope (DOM) and cone-beam computed tomography (CBCT), a missed distolingual canal was successfully identified along with the mesiobuccal, mesiolingual, and distobuccal canals. The root canals were prepared, disinfected, and densely obturated.
Conclusion:
This report highlights the importance of detailed root canal exploration using advanced diagnostic tools like DOM and CBCT to ensure the successful management of rare anatomical variations in mandibular premolars.