Endodontic management of three rooted maxillary first and second premolars: two case reports

Before initiating endodontic treatment external root morphology, root number and canal system and possible variations and anomalies should always be considered. These variations make diagnosis and treatment clinically challenging. Failure to recognize the presence of an additional canal or root may result in unsuccessful treatment and may be the origin of acute flare-ups during and after treatment. Endodontic success in teeth with variations requires a correct radiographic diagnosis and careful clinical intervention. An awareness and understanding of the presence of unusual root canal morphology can thus contribute to the successful outcome of root canal treatment. Relatively few case reports of variations and anomalies in maxillary first and second premolars have been published. We are reporting here endodontic treatment of a maxillary first and second premolar with three distinct roots and three distinct foramens with the aim of highlighting the diagnosis and clinical management of these rare variations.