Endodontic treatment of a mandibular first premolar with three root canals: a case report

Background: A correct diagnosis of the morphology of the root canal system is crucial in order to ensure a successful root canal treatment. The incidence of mandibular first premolars with three root canals has been reported to be low. This clinical case report describes a case of a successful nonsurgical endodontic management of a mandibular first premolar with three root canals. Case presentation: A 27-year-old man presented to our clinic with pain in the left mandibular premolar. The diagnosis was irreversible pulpitis based on the clinical and radiographic examinations. Hence, root canal treatment was recommended. After preparing the access cavity, the orifices were found by removing the dentinal shelves. The root canals were treated by rotary files and were obturated using the cold lateral compaction technique. Conclusion: Mandibular premolars can present with an extremely complex root canal morphology, which if not considered during the treatment, it can lead to post-treatment complications, failure, or flare-ups.