Unraveling the enigma: A case report

The purpose of this case report is to emphasize the importance of cone-beam computed tomography (CBCT) and dental operating microscope for endodontic treatment on mandibular second premolar with three separate roots. In endodontics, the possible existence of extra canals must be considered before endodontic treatment is instituted. A wide morphological variation of the mandibular second premolar is known to exist. The incidence of a three-rooted mandibular second premolar is approximately 0.4%. A 43-year-old female patient was referred for endodontic treatment on the mandibular second premolar. IOPA revealed three roots, and hence for confirmation, a CBCT image was taken and root canal treatment was performed under an operating microscope for enhanced visualization. This case report describes the successful endodontic treatment of a mandibular second premolar with three separate roots and canals filled using gutta-percha and AH Plus. Clinical significance: Conventional endodontic treatment can be performed on a tooth with complex root canal morphology using an operating microscope.