Mandibular second premolar with three root canals: a case report

• Introduction: Mandibular second premolars with three canals and separate foramina are very rare. A review of the literature has revealed that human mandibular premolar tooth can have an extremely complex root and root canal morphology; however, incidence of both multiple roots and multiple canals in mandibular second premolar is lower than that found in mandibular first premolar. • Aim: To report and discuss endodontic management for an unusual occurrence of three canals with three separate foramina in mandibular second premolar. • Materials and methods: Description of the root canal anatomy and management for a case of mandibular premolar with three root canals for an 18 year old African American male patient, where pulp chamber floor revealed one lingual and two buccal orifices at the same level. This report was clinically and radiographically based. • Conclusion: The complex nature of root and root canal morphology of mandibular premolars has been underestimated, which resulted in unknown endodontic failures in many clinical cases. Proper diagnosis and orientation with the root canal anatomy is mandatory for successful treatment.