Endodontic Management of Three-Rooted Maxillary Premolars: A Clinical Case Series
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Abstract
Background
Anatomical variations in maxillary premolars can significantly influence the outcome of endodontic treatment. Although these teeth typically present with one or two roots, the occurrence of three distinct roots and canals is uncommon and may remain undetected when conventional diagnostic methods are relied upon. Missed canals continue to represent a major cause of post-treatment disease, underscoring the need for accurate assessment of root canal morphology before and during treatment.
Case presentation
This case series reports three patients—two maxillary first premolars and one maxillary second premolar—with three separate roots and canals. Clinical examination was supplemented by multiple angulated periapical radiographs and 5× magnification to confirm the canal anatomy. All teeth underwent non-surgical root canal treatment following standardised clinical protocols. Canal preparation was performed using nickel–titanium rotary instruments, with irrigation using sodium hypochlorite and ethylenediaminetetraacetic acid for smear layer removal. Obturation was completed using a single-cone technique with gutta-percha and a bioceramic sealer. Definitive coronal restorations were placed in all cases. At clinical and radiographic follow-up, all treated teeth were asymptomatic and demonstrated favourable outcomes.
Conclusion
This case series highlights the importance of systematic radiographic evaluation, magnification, and contemporary endodontic techniques in the successful management of three-rooted maxillary premolars.
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References
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