# Exploring anatomical variations of mandibular premolars and their clinical management: a case series

## TL;DR

This paper presents three cases of unusual root canal configurations in mandibular premolars and discusses their clinical management using advanced diagnostic tools.

## Contribution

The study contributes new clinical insights into rare canal configurations in mandibular premolars and their successful treatment approaches.

## Key findings

- Three mandibular premolars exhibited rare canal configurations (Sert and Bayirli Type IX, Vertucci Types V and IV).
- Cone-beam computed tomography (CBCT) was effective in identifying complex canal morphologies.
- Magnification and precise biomechanical preparation improved endodontic therapy outcomes.

## Abstract

Anatomical variations in root canals pose significant challenges and may affect the course of treatment. Mandibular premolars usually have a single canal with single root. However, this case series highlights three mandibular premolars with distinct canal configurations. The first case involved a mandibular second premolar with Sert and Bayirli Type IX anatomy, characterised by one canal trifurcating into three different canals at the apex. In the second case, the Vertucci Type V configuration is in the mandibular second premolar. In the third case, a mandibular first premolar showed a Vertucci Type IV configuration, which remained distinct throughout its course. Cone-beam computed tomography (CBCT) is a reliable diagnostic tool for identifying these intricate canal morphologies. The use of magnification ensured through biomechanical preparation and obturation, which contributes to the success of endodontic therapy.