Endodontic Retreatment of a Mandibular First Premolar With Unusual Four Root Canal Morphology: A Case Report.

INTRODUCTION

Mandibular premolars exhibit complex root canal systems, making them highly challenging to manage endodontically. Canal configurations vary from one to five canals. Successful endodontic treatment requires a thorough knowledge of standard anatomy and its variations.

CASE PRESENTATION: This case report presents the endodontic retreatment of a right mandibular first premolar with four separate root canals in a 36-year-old male. Initial clinical and radiographic examinations showed a complex root canal anatomy. With the aid of a dental operating microscope (DOM) and cone-beam computed tomography (CBCT), a missed distolingual canal was successfully identified along with the mesiobuccal, mesiolingual, and distobuccal canals. The root canals were prepared, disinfected, and densely obturated.

CONCLUSION

This report highlights the importance of detailed root canal exploration using advanced diagnostic tools like DOM and CBCT to ensure the successful management of rare anatomical variations in mandibular premolars.