Management of a 3-canal mandibular premolar in a patient with unusual root canal anatomy in all mandibular premolars.

Endodontic treatment of mandibular premolars can be difficult due to their aberrant root canal anatomy. Successful nonsurgical root canal treatment requires knowledge of basic root and root canal morphology, and possible anatomical variations of the root canal system. Mandibular second premolars usually have a single root and a single canal, and the presence of 3 canals in separate roots is very rare. Nonsurgical endodontic treatment of such teeth is a challenge. This article presents a rare case of a mandibular second premolar with 3 root canals in separate roots and its endodontic management, with a special emphasis on radiographic interpretation and access refinement during treatment.