Unusual anatomy of a mandibular first premolar

Nonsurgical root canal therapy was performed on #21 with unusual morphology. (See images 1-3)

  1. Pre-operative radiograph

2. Intra-operative radiograph

3. Post-operative radiograph

Thorough knowledge of tooth morphology and root canal anatomy is a pre-requisite for RCT success. This includes an understanding of the frequency and types of variations that can occur in each tooth. As it pertains to this case, lower 1st premolars contain more than one root in only 0.3% of cases, as was reported in a recent literature review (posted below). And, as usual, multiple pre-operative shift-shots can also be used as an aid for detecting aberrant anatomy.

http://www.sciencedirect.com/science/article/pii/S0099239906011782

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