Cone-beam Computed Tomographic Evaluation and Endodontic Management of a Mandibular First Premolar with Type IX Canal Configuration: Case Report

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Mandibular premolars exhibit considerable variations in their root canal system that can be particularly difficult to diagnose. Avoiding mishaps and successful nonsurgical endodontic therapy depends on an absolute understanding of the root and root canal morphology to locate, prepare, and obturate the canals.


This case report describes the endodontic therapy of a mandibular first premolar with 2 roots and 3 canals with confirmation of cone-beam computed tomography. It also cites the incidence of morphologic variations reported in mandibular first premolars, based on ethnic diversity.


Cone-beam computed tomography (axial and sagittal sections) confirmed the presence of 2 roots and 3 canals in a mandibular first premolar. Here, the main canal divided into 3 root canals at the middle third, otherwise described as Sert and Bayirli's type IX canal configuration.


The occurrence of documented cases of a mandibular first premolar with Sert and Bayirli's type IX root canal configuration is rare. Failure to recognize a second and third canal in the present case might have otherwise resulted in endodontic reinfection.

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