Single-Visit Root Canal Treatment on a Mandibular First Premolar with Three Root Canals

Authors

  • Achmad Junaidi Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Indonesia
  • Annisa Fitria Sari Universitas Airlangga, Indonesia

DOI:

https://doi.org/10.59141/-.v8i1.500

Keywords:

anatomical variations, vertucci, root canal treatment

Abstract

Background: In root canal treatment, accurate diagnosis of root canal morphology is crucial for treatment success. Vertucci reported that in mandibular premolars, 74% have one canal, 25.5% have two canals, and 0.5% have three canals. Therefore, pre-treatment radiography, careful examination, and appropriate techniques are essential to identify root canal orifices, especially in cases with canal variations. The purpose of this case report is to demonstrate the importance of knowledge about the morphology of the root canal system and how to manage root canal care in the first premolar tooth of the lower jaw with three root canals. Case: A 57-year-old female patient with a complaint of a large cavity of the left lower jaw premolar tooth, no pain and wants to be treated. The radiographic results showed that the tooth pulp was open and the morphology of the root canal showed that there were three root canals. Management: Access opening and search of three root canals is carried out using ultrasonic tips and magnification assistance with a dental microscope. The root canal is prepared with rotary NiTi fileby irrigation using 5.25% sodium hypochlorite, 17% EDTA. Obturation using thermal fill and the use of dental crowns as final restoration will be done at the next visit. Conclusion: An understanding of the morphology of the root canal system and the proper use of tools and materials will influence success in the treatment of complex root canals in premolar teeth with three root canals.

Downloads

Download data is not yet available.

References

Ahmed, H. M. A., & Dummer, P. M. H. (2018). A new system for classifying tooth, root and canal anomalies. International Endodontic Journal, 51(4), 389–404. https://doi.org/10.1111/iej.12867

Ahmed, H. M. A., Versiani, M. A., De-Deus, G., & Dummer, P. M. H. (2023). Root and canal morphology of mandibular premolars: a systematic review and meta-analysis. Journal of Clinical Medicine, 12(6), 1–16. https://doi.org/10.3390/jcm12062183

Al-Zubaidi, S. M., Almansour, M. I., Alshammari, A. S., Al Mansour, N. N., Alshammari, A. F., Altamimi, Y. S., & Madfa, A. A. (2022). Root and canal morphology of mandibular premolars in a Saudi subpopulation: a cone-beam computed tomography study. International Journal of Dentistry, 2022, 4038909. https://doi.org/10.1155/2022/4038909

Almeida, J. C., Candemil, A. P., Bertolini, G. R., Souza-Gabriel, A. E., Cruz-Filho, A. M., Sousa-Neto, M. D., & Silva, R. G. (2023). Cone-beam computed tomographic evaluation of the root canal anatomy of the lower premolars and molars in a Brazilian sub-population. Imaging Science in Dentistry, 53(1), 77–82. https://doi.org/10.5624/isd.20220100

Alsofi, L., Al-Habib, M., Zahran, S., Alsulaiman, M., Barayan, M., Khawaji, S., Sanari, M., Altorkestani, M., Alshehri, L., Zarei, L., Almarghlani, A., & Howait, M. (2025). Three-dimensional evaluation of root canal morphology in mandibular premolars of Saudi individuals: a CBCT study. Libyan Journal of Medicine, 20(1), 2464292. https://doi.org/10.1080/19932820.2025.2464292

Arayasantiparb, R., & Banomyong, D. (2021). Prevalence and morphology of multiple roots, root canals and C-shaped canals in mandibular premolars from cone-beam computed tomography images in a Thai population. Journal of Dental Sciences, 16(1), 201–207. https://doi.org/10.1016/j.jds.2020.06.010

Chang, S. W., Lee, J. K., Lee, Y., Kum, K. Y., & Bae, K. S. (2021). Root canal morphology of mandibular premolars in a Korean population using cone-beam computed tomography. BMC Oral Health, 21(1), 1–8. https://doi.org/10.1186/s12903-021-01447-w

Cleghorn, B. M., Christie, W. H., & Dong, C. C. S. (2017). The root and root canal morphology of the human mandibular first premolar: a literature review. Journal of Endodontics, 43(5), 1–9. https://doi.org/10.1016/j.joen.2006.12.004

Elsherif, A., Zayet, M., Hamdy, T., & Ahmed, H. (2024). Prevalence of multiple roots and complex root canal morphology in mandibular premolars using CBCT analysis. Odontology, 112(2), 1–10. https://doi.org/10.1007/s10266-023-00858-5

Hameed, M. H., Suresh, S., Kalhoro, F. A., Rani, P., Memon, M., Alvi, M., & Rajput, F. (2024). Root canal morphology of premolars in population of Hyderabad, Pakistan: a cone beam computerised tomographic analysis. Journal of the College of Physicians and Surgeons Pakistan, 34(10), 1238–1244. https://doi.org/10.29271/jcpsp.2024.10.1238

Hargreaves, K. M., & Berman, L. H. (2021). Cohen’s Pathways of the Pulp (12th ed.). Elsevier.

Karobari, M. I., Batul, R., Patil, S. R., & Basheer, S. N. (2024). Micro computed tomography (Micro-CT) characterization of root and root canal morphology of mandibular first premolars: a systematic review and meta-analysis. BMC Oral Health, 24(1), 1. https://doi.org/10.1186/s12903-023-03624-5

Karobari, M. I., Iqbal, A., Syed, J., Batul, R., Adil, A. H., Khawaji, S. A., Howait, M., Khattak, O., & Noorani, T. Y. (2023). Evaluation of root and canal morphology of mandibular premolar amongst Saudi subpopulation using the new system of classification: a CBCT study. BMC Oral Health, 23(1), 291. https://doi.org/10.1186/s12903-023-03002-1

Martins, J. N. R., Ordinola-Zapata, R., Herrera, D. R., Lucas, J. M., & Caramês, J. (2020). Differences in root canal system configuration in human permanent teeth within different age groups: a superimposed diagnostic study by two different methodologies. Clinical Oral Investigations, 24(1), 331–341. https://doi.org/10.1007/s00784-019-02955-6

Martins, J. N. R., Pereira, B., Igreja, I., & Lambrianidis, T. (2025). Population-specific anatomical variations in premolar root canal systems: a cross-sectional cone-beam computed tomography study of Jamaican and Portuguese subpopulations. Journal of Clinical Medicine, 14(4), 1210. https://doi.org/10.3390/jcm14041210

Patel, S., Barnes, J., Mannocci, F., & Patel, K. (2016). Endodontic Treatment, Retreatment and Surgery. Springer.

Prapayasatok, S., Songsiripradubboon, S., Pongsiriwet, S., & Kanjanapongkul, K. (2021). Root and canal morphology of mandibular premolars in a Thai population using cone-beam computed tomography. BMC Oral Health, 21(1), 1–8. https://doi.org/10.1186/s12903-021-01578-0

Thanaruengrong, P., Kulvitit, S., Navachinda, M., & Lertchirakarn, V. (2021). Prevalence of complex root canal morphology in the mandibular first and second premolars in Thai population: CBCT analysis. BMC Oral Health, 21(1), 449. https://doi.org/10.1186/s12903-021-01822-7

Vertucci, F. J. (2015). Root canal morphology and its relationship to endodontic procedures. In K. M. Hargreaves & L. H. Berman (Eds.), Cohen’s Pathways of the Pulp (11th ed., pp. 136–222). Elsevier.

Wolf, T. G., Anderegg, A. L., Wierichs, R. J., & Campus, G. (2021). Root canal morphology of the mandibular second premolar: a systematic review and meta-analysis. BMC Oral Health, 21(1), 309. https://doi.org/10.1186/s12903-021-01668-z

Downloads

Published

2026-03-31

How to Cite

Junaidi, A., & Sari, A. F. (2026). Single-Visit Root Canal Treatment on a Mandibular First Premolar with Three Root Canals. Jurnal Sehat Indonesia (JUSINDO), 8(1), 267–274. https://doi.org/10.59141/-.v8i1.500