Mandibular first premolar with five root canals: a case report
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CASE REPORT
Open Access
Mandibular first premolar with five root canals: a case report Ming Zhang1, Jian Xie2, Yan-huang Wang1 and Yan Feng3*
Abstract Background: Understanding the anatomical morphology of the root canal is key for successful root canal treatment. The aims of this case presentation are to report a unique case of root canal treatment involving five root canals in the mandibular first premolar and to highlight the importance of variation in root canals of mandibular first premolars in clinical practice. Case presentation: A 25-year-old male with intermittent pain in relation to the lower right posterior teeth over 3 weeks was diagnosed with symptomatic pulpitis in tooth #44. Four root canals were found, including mesiobuccal, distobuccal-1, distobuccal-2, and distolingual roots, and the Mtwo rotary system was used for root canal preparation. The four root canals were filled after 2 weeks, when a fifth canal was found, located in the buccal cavity. The fifth canal was confirmed to be the mesiolingual root canal by cone beam computed tomography (CBCT) and was found to be curved. After completion of the root canal filling, CBCT was performed, and a threedimensional root canal image was reconstructed. After 1 week of observation, the tooth was repaired using composite resin filling. Conclusions: This is the first case presentation of a fifth canal of the mandibular first premolar and advances our understanding of variations in the anatomy of the mandibular first premolar. This case report provides a reference for the treatment of mandibular first premolars. Keywords: Anatomic variation, Dental operating microscope, Root canal system, Endodontic treatment, Case report
Background The purpose of root canal treatment is to clear pathogenic microbes and infected pulp in the root canal, prevent it from producing toxic products, and protect the periapical tissue [1, 2]. The presence of root canal variation increases the difficulty of this treatment [3–5]. It has been reported that 42% of retreatment cases are due to missing canals [6]. Therefore, there is great clinical significance for dentists to master the morphological characteristics of root canals. Branch root canals are common morphological * Correspondence: [email protected] 3 Fujian Provincial Engineering Research Center of Oral Biomaterial & Institute of Stomatology & Department of Preventive Dentistry, School and Hospital of Stomatology, Fujian Medical University, 246 Yang Qiao Middle Road, Fuzhou 350002, China Full list of author information is available at the end of the article
variations in root canal systems, whose morphology can present either as one or more small lateral branches from the main root canal or as two equally large bifurcated root tips on the apical segment [7, 8]. The anatomical variations in the root canal system of the mandibular first premolar are known [9–15]. For example, in an Egyptian population, it was shown that 96.8% of root canals of mandibular first premolars present as a single canal, and 3.2% present as t
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