Endodontic Management of a Maxillary Premolar with a Rare Configuration (Three Buccolingually Positioned Canals in a Single Root) as Confirmed by Cone Beam Computed Tomography: a Case Report

Missed canals pose a potential risk in the treatment of teeth with anatomical variations, even when multi-angled radiographs have been used. Incomplete mechanical and chemical debridement of the root canal system can lead to treatment failure. Therefore, clinicians must have adequate knowledge of normal root canal systems as well as any possible variations in order to prevent any failure during or after the treatment of teeth with anatomical variations. Any case report of such rare variations would add to this critically required body of knowledge. The current case report presents the diagnosis and endodontic treatment of a maxillary first premolar with one root and three canals (one palatal and two buccal canals, all buccolingually positioned, bifurcating in the apical region), which was different from premolars with 3 canals reported up to now. This configuration describes an unusual root canal system for the maxillary first premolar and does not fit into any of the well-known root canal classification systems.