title: Mandibular first premolar with four canals.
abstract: A case of endodontic treatment of a mandibular first premolar exhibiting a total of four distinct root canals and four apical foramina is described. This occurrence in mandibular first premolar has rarely been reported in the endodontic literature. Endodontic treatment that considers the anatomic variation of root canal morphology is important to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly-radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation with ethylenediaminetetraacetic acid might allow the flow of sealer into the narrowed but unprepared part of the canal. This offers valuable adjuncts for the successful negotiation of calcified main canals, thereby facilitating optimum chemo-mechanical debridement of the root canal system.
authors: Department of Operative Dentistry and Endodontics, Jinan Stomatological Hospital, Jinan, China.
authors: Yi
authors: Y
authors: Du
authors: Angeline H C
authors: AH
authors: Lee
authors: Chengfei
authors: C
authors: Zhang
mesh_terms: D063405:Anatomic Variation; D001641:Bicuspid / Q000002:abnormalities*; D003287:Contrast Media; D003786:Dental Pulp Cavity / Q000002:abnormalities*; D004492:Edetic Acid / Q000627:therapeutic use; D004853:Epoxy Resins / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible; D008853:Microscopy / Q000295:instrumentation; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000628:therapy; D011671:Pulpitis / Q000628:therapy; D012387:Root Canal Filling Materials / Q000627:therapeutic use; D012388:Root Canal Irrigants / Q000627:therapeutic use; D012389:Root Canal Obturation / Q000379:methods; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000379:methods; D019227:Tooth Apex / Q000002:abnormalities; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods
chemical_list: D003287:Contrast Media; D004853:Epoxy Resins; D012387:Root Canal Filling Materials; D012388:Root Canal Irrigants; C534916:epoxy resin-based root canal sealer; D004492:Edetic Acid