title: Diagnosis and root canal treatment in a mandibular premolar with three canals.
abstract: This paper presents a case report of a left mandibular second premolar with three canals and three different apical foramina. A 39-year-old male patient presented to our clinic with pain in the mandibular left second premolar. Initially, pain was caused by cold stimulus and later was spontaneously. The intraoral clinical examination revealed a fractured amalgam restoration with occlusal caries. Percussion and cold (Endo-Frost) tests were positive. The radiographic examination showed the presence of two roots. The probable diagnosis was an acute pulpitis. After access cavity, it was observed remaining roof of the pulp chamber and mild bleeding in the tooth lingual area, indicating the possible presence of a third canal. The endodontic treatment was completed in a single session using Root ZX apex locator and K3 NiTi rotary system with surgical diameter corresponding to a .02/45 file in the three canals and irrigation with 1% sodium hypochlorite. The canals were obtured with gutta-percha cones and Sealer 26 using the lateral condensation technique. After 1 year of follow-up, the tooth was asymptomatic and periapical repair was observed radiographically. Internal alterations should be considered during the endodontic treatment of mandibular second premolars. The correct diagnosis of these alterations by the analysis of preoperative radiographs can help the location of two or more canals, thereby avoiding root therapy failure.
authors.affiliation: Dental School, Federal University of Goiás, Goiania, GO, Brazil.
authors.forename: Lanuce Rosa
authors.initials: LR
authors.lastname: Soares
authors.forename: Marcos
authors.initials: M
authors.lastname: Arruda
authors.forename: Marcos Pôrto
authors.initials: MP
authors.lastname: de Arruda
authors.forename: Andréa Leão
authors.initials: AL
authors.lastname: Rangel
authors.forename: Edson
authors.initials: E
authors.lastname: Takano
authors.forename: Jacy Ribeiro
authors.initials: JR
authors.lastname: de Carvalho Júnior
authors.forename: Paulo Cesar
authors.initials: PC
authors.lastname: Saquy
mesh_terms: D000328:Adult; D001641:Bicuspid / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology; D003786:Dental Pulp Cavity / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008297:Male; D008334:Mandible; D009811:Odontometry / Q000295:instrumentation; D010485:Periapical Periodontitis / Q000628:therapy; D011671:Pulpitis / Q000628:therapy*; D011859:Radiography; D012389:Root Canal Obturation; D018915:Root Canal Preparation / Q000295:instrumentation / Q000379:methods*; D014092:Tooth Root / Q000033:anatomy & histology* / Q000000981:diagnostic imaging / Q000473:pathology