Treatment of Maxillary Second Premolar with 4 Roots

Abstract

Aim. To report a case of maxillary second premolar with four roots and four separate foramina and the use of CBCT to help identify the root canal system configuration. Summary. A 45-year-old female patient with a no significant medical history was referred for treatment tooth #15. The tooth was diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis. After taking periapical radiographs and expected uncommon morphology, CBCT was taken to help confirm canals configuration and aid in the treatment of the case. Root canals treatment was carried without complication under dental operating microscope using a rotary system and continuous wave obturation.

Maxillary Premolars with Four Canals: Case Series

“…Accurate radiographic examination using horizontal angle variation provides notable support for the endodontist to distinguish the roots and root canals and formulate a correct diagnosis, also in challenging anatomical configurations, as previously reported [ 12 , 13 , 14 ]. Furthermore, the detection of the pulp chamber anatomy during coronal access and adequate intracanal dentin removal contribute to the correct clinical location of the root canal orifices [ 12 ].…”

“…Previous case reports have shown several canal and root configurations in three-canal maxillary premolars: three canals in a single root, two canals in the buccal root and one in the palatal root, three separate roots and canals [ 10 , 11 , 12 ]. Only two studies have described four separate canals in a three-rooted premolar [ 13 , 14 ].…”