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Most mandibular second molars are usually found to have two roots (76%) or one root (22%). The incidence of 3 roots anatomy in such teeth is considered a rare finding (less than 2% in some researches). The incidence of 3 rooted lower second molar with 4 separate canals is considered very rare.  This is a […]

The second maxillary premolar  may have 1 to 3 roots: with one root canal in 75-96% of cases, with two root canals in 4-24% and three root canals in 0-1%. Careful interpretation of preoperative radiographs is essential for providing insight into the number of existing root canals. In maxillary premolars with multiple roots and canals, […]

Middle mesial canal (MMC) is an additional canal found in mandibular first molars. The knowledge of its presence and its detection, negotiation, disinfection and sealing plays paramount importance in the overall endodontic success. 

As endodontists we often encounter retreatment cases with procedural errors such as canal blockages, ledges, instrument fractures and perforations.  The ledge is defined as an iatrogenic deviation from the original canal path that does not communicate with the periodontal ligament. The presence of a ledge prohibits the files from reaching the canal terminus, resulting in […]

The maxillary first molar typically exhibits complex root canal anatomy, commonly presenting with three roots—two buccal and one palatal. However, anatomical variations, such as the presence of a fourth root, can occur and significantly impact endodontic treatment. Recognizing these variations is crucial for successful root canal therapy. This article discusses the endodontic management of four-rooted […]

In retreatment cases , the clinician has to deal with many mishaps such as underfilled, missed and obstructed canals as also with iatrogenic damages as separated instruments and perforations. Underfilled and missed canals are the main reasons for endodontic failures (>30%).Especially underfilling can be a real challenge since it can strongly reduces the success rate […]

The clinician must be aware of the possible anatomical variations of these teeth and their relationship to adjacent anatomical structures when planning and performing endodontic procedures.

Root perforations were the second greatest cause of failure accounting for 9.62% of all unsuccessful cases. Seltzer et al. also attributed 3.52% of all endodontic failures to perforation. This perforation if left untreated leads to act as a pathway for microorganisms either from periodontal tissues or perforation site, results in secondary periodontal infection, suppuration, fistula […]

Modern endodontic treatment is based on optimal cleaning,disinfection and high-quiality obturation of the root canal system.Anatomy is considered as a key factor in the healing process.That is why a clinician have to be aware of all normal,possible and abnormal variations in the teeth anatomy for achieving a maximum clinical success.In the article presents clinical example that demonstrate the complexity of endodontic retreatment of the maxillary left premolar

A 23 years old, female patient, was referred to my practice for an endodontic treatment on tooth 11. Patient complained of pain above the root and was concerned of the discoloration. Patient reported  previous trauma (15 years ago) and an attempted endodontic treatment (5 years ago).

Premolars are the most versatile teeth in regards of anatomy. One of the most challenging anatomical variations we have to face is dilaceration. Abrupt curvatures complicate the RCT especially when we have more than one. 

A periapical pathology, could be a result of caries, trauma, periodontally compromised oral cavity or even a thermal and chemical insult to the tooth. Effective cleaning, shaping and disinfection is the key to a successful endodontic treatment. A deep understanding of the anatomy of a root canal system, is of high value while performing a non-surgical root canal treatment. We often come across mandibular premolars with aberrant root canal anatomies. They often present with multiple canals, splits and accessory canals.
This article describes a case of NSRCT of a mandibular premolar with 1-2 configuration and it presented with a big peri-apical radiolucency.