Use of CBCT in the endodontic management of a second mandibular premolar with three roots: clinical case

Abstract

Background: Reports and studies on dental anatomy describe variations in the morphology, number and shape of the roots and root canals, with the mandibular premolars being one of the dental groups with special complexity. In the bibliographic review published on the morphology of mandibular second premolars, the presence of three roots being extremely rare, finding differences according to the ethnic group studied. The aim of this case is to describe an unusual case of the anatomy of a mandibular second premolar. Materials and Methods: A 59-year-old male patient presented with pain in the right mandibular second premolar. After taking the clinical history and the examination, he was diagnosed with irreversible serous pulpitis. Endodontic emergency treatment was started with the location of two root canals and the suspicion of two roots, according to radiographic examination. After performing CBCT, the presence of a third root was discovered in 45 and the presence of another anatomical variant in the right mandibular first premolar (44) Results: Endodontic treatment was performed in the three canals of 45 (mesio-vestibular, disto-vestibular and lingual). Clinical controls were carried out at 12 and 18 months. Conclusions: With the limitations of this clinical case, we can conclude that Anatomical knowledge is essential for performing endodontic treatment. The study of the tooth with CBCT is essential in cases where the anatomy of the tooth shows abnormalities in the radiographic study.