Main Article Content
The success of endodontic treatment is dependent on the cleaning, shaping, and obturation of the root canal system, which includes well-sealed coronal restoration to prevent leakage, reinfection of the root canal and prevent tooth fracture. Mandibular first premolars are difficult to treat due to variations in the root canal morphology. The incidence of mandibular first premolars with one canal is 54-82.1%, two canals is 11.2-34.27%, and three canals is 0-3%.
The aim of this case report was to present the successful endodontic treatment of a right mandibular first premolar with three canals using dental loupes, apex locator and modification of the root canal access opening. After a one-year follow-up, it was found that the treatment outcome was favorable. The teeth could function as normal with no abnormal clinical symptoms, and the healing of the periapical pathology could be seen from the radiographic examination.
2. Walker RT. Pulp space anatomy and access cavities. In: Pitt TR, editors. Harty’sendodontics in clinical practice.4thed. London: Butterworth-Heinemann; 1997. p18.
3. Walton RE, Vertucci FJ. Internal anatomy. In : Walton RE, Torabinejad M, editor, Principles and practice of endodontics. Philadelphia:WB Saunders;1996.p166-79.
4. Zillich R, Dowson J. Root canal morphology of mandibular first and second premolar. Oral Surg Oral Med Oral Pathol 1973; 36:738-44.
5. Vertucci FJ. Root canal anatomy of human permanent teeth. Oral Surg Oral Med Oral Pathol 1984; 58 :589-99.
6. Baisden MK, Kulid JC, Weller RN . Root canal configuration of the mandibular first premolar, J Endod 1992;18:505-8.
7. Lu TY, Yang SF, Pai SF. Complicated root canal morphology of mandibular first premolar in a Chinese population using the cross section method. J Endod 2006; 32:932-6.
8. Islam MA ,Wakia T, Alam S.. Root canal Morphology of mandibular first premolars of bangladeshi population. UpDCJ 2012; 2(2) : 3-7.
9. Yu X, Guo B, Li KZ, Zhang R, Tian YY, Wang H, et al. Cone– beam computed tomography study of root canal morphology of mandibular premolars in a western Chinese population. BMC Med Imaging 2012;12:18.
10. Habib AA,Kalaji MN, Tyseer J. AI saysd TJ, AI jawfi KA. Root canal configurations of the first and second mandibular premolars in the population of north Syria. Journal of Taibah University Medical Sciences 2015;10: 391-5.
11. Dou L, Li D, Xu T, Tang Y, Yang D. Root anatomy and canal morphology of mandibular first premolars in a Chinese population. Sci Rep 2017;7:750.
12. Sharma B, Nabhi K , Sheikh S, MehraP.Anatomic variations and anomalies in mandibular first premolar teeth. J Adv Med Med Res 2018;25:1-9.
13. Slowey RR. Root canal anatomy. road map to successful endodonticsDentclin of endodontics. Dent Clin North Am 1979; 23:555 –73.
14. Srimawong P. Cone Beam Computed Tomography in Dentistry. J Dent Assoc Thai 2008 ;23,26-38.
15. Tarathorn Suntrornkiat,Norachai Wongkornchawit. Endodontic Routine Cases:Looking to Complete the End.Bangkok:Amarin printing and publishing;2018.
16. Rhodes JS. A case of unusual anatomy: a mandibular premolar access opening. Int Endod J 2001;34:645-8.
17. Rodig T, Hulsmann M. Diagnosis and root canal treatment of a mandibular second premolar with three root canal. Int Endod J 2003;36:912-9.
18. Baumgartner JC, Ibay AC. The chemical reactions of irrigants used for root canal debridement. J Endod 1987;13:47-51.
19. Shih M, Marshall FJ, Rosen S. The bactericidal efficiency of sodium hypochlorite as an endodontic irrigant. Oral Surg Oral Med Oral Pathol 1970;29:613-9.
20. Bystrom A, Sundqvist G. Bacteriologic evaluation of the efficacy of mechanical root canal Instrument in endodontic therapy. Scand J Dent Res 1981;89:321-8
21. Bystrom A, Claesson R, Sundqvist G. The antimicrobial effect of camphorated paramonochlophenol, camphorated phenol and calcium hydroxide in the treatment of infected root canal. Endod Dent Traumatol 1985;1:170-5.
22. Friedman S. Prognosis of initial endodontic therapy. Endod Topics 2002;2:59-88.