Endodontic Management of Non-single Root Canal Mandibular Premolars

Mandibular premolars and more often the first mandibular premolar, have some of the most complex endodontic configurations.With 1, 2 or 3 roots or root canals, C-shaped configurations, narrow endodontic space and bifurcations in the middle and apical thirds, all these are factors that make endodontic treatment of these teeth challenging.In order to endodontically treat these teeth, we need to know their anatomical variations and their prevalence, as some of them are quite frequent.Moreover, periapical radiograph does not always succeed in exposing aspects that suggest these multiple canal configurations.Current diagnostic means such as Cone-Beam Computed Tomography (CBCT), but also clinical endodontic armamentarium (operating microscope, ultrasound and the new nickel titanium files), are important resources when dealing with these teeth.Along with clinical expertise and sound knowledge of endodontic anatomy they play a crucial role to prevent endodontic errors.The purpose of this paper is to outline clinical management of these teeth, that would be beneficial to achieve a successful endodontic treatment.