Abstract

Success in root canal treatment often combines a thorough anatomical knowledge of tooth morphology, proper debridement and a 3-dimensional obturation followed by a good hermetic seal and post endodontic restoration. Failure to achieve efficacy in any of the above steps often leads to the failure of the root canal treatment. Straight access to additional canals is also restricted by the relatively small diameter of the tooth. A patient presented to our practice with a history of severe pain in the lower left side tooth region for the past 2 days. Intra oral examination revealed that there was a fractured restoration in relation to tooth#34 and the tooth was highly tender on percussion. Radiographic examination revealed variation in the radicular anatomy unusual to this tooth and we found the tooth to have 2 separate roots with 2 different canals of different entry. Root canal therapy was successfully completed for the patient and post-operative radiograph was taken. The patient was recalled after 5 days for initial review and found to be asymptomatic. This case report presents the root canal treatment of mandibular first premolar with a unique radicular anatomy with 2 roots having 2 distinct canals and separate exits. Mandibular first premolars presenting with 2 roots having 2 distinct canals and separate exits (Vertucci classification IV) are quite rare and minimally documented in literature; the incidence of two roots in mandibular first premolar is found to be 1.8%.

Keywords:Furcation; Mandibular premolars; Morphology; Root canal therapy; Case report