Carina Lea1, Jason Deblinger1, Ricardo Machado2, Emmanuel João Nogueira Leal Silva3, Luiz Pascoal Vansan2. 1. Private Practice, New York, New York. 2. Endodontics Division, São Paulo University, Ribeirão Preto, São Paulo, Brazil. 3. Health Sciences Center, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil. Electronic address: nogueiraemmanuel@hotmail.com.
Abstract
INTRODUCTION: Recognition of anatomic variations is a challenge for clinicians regardless of which tooth is treated. Maxillary premolars usually have 2 root canals, but the presence of 3 distinct root canals has been reported in 1%-6% of cases. METHODS AND RESULTS: This report describes the case of a maxillary right second premolar with 4 separate canals: 1 mesial, 1 palatal, and 2 distal canals. This was confirmed by using cone-beam computed tomography and was successfully treated with rotary files and obturated by using a warm vertical compaction technique. CONCLUSIONS: The clinical significance of the present case is that this is the first report of 3 roots and 4 separate canals in a maxillary premolar. Precise knowledge of root canal morphology and its variation is also underlined. Cone-beam computed tomography examination and the operating microscope are excellent tools for identifying and managing these complex root canal systems.
INTRODUCTION: Recognition of anatomic variations is a challenge for clinicians regardless of which tooth is treated. Maxillary premolars usually have 2 root canals, but the presence of 3 distinct root canals has been reported in 1%-6% of cases. METHODS AND RESULTS: This report describes the case of a maxillary right second premolar with 4 separate canals: 1 mesial, 1 palatal, and 2 distal canals. This was confirmed by using cone-beam computed tomography and was successfully treated with rotary files and obturated by using a warm vertical compaction technique. CONCLUSIONS: The clinical significance of the present case is that this is the first report of 3 roots and 4 separate canals in a maxillary premolar. Precise knowledge of root canal morphology and its variation is also underlined. Cone-beam computed tomography examination and the operating microscope are excellent tools for identifying and managing these complex root canal systems.