PMC2647961_01
Periapical radiograph, showing the complex root morphology of the premolar suggesting the existence of three root canals.
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A preoperative periapical radiograph confirmed the presence of a carious lesion on the distal surface of maxillary first premolar (Figure 1).
Periapical radiograph of the opposite side showing a similar anatomical conformation.
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The periapical radiograph of the opposite side had a similar anatomical conformation (Figure 2).
Radiographical confirmation of three root canals and determination of the working lengths.
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The working length was established with apex locator (Root ZX, Morita, USA) and confirmed radiographically for each root (Figure 3).
Periapical radiograph after obturation of the three root canals.
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The canals were dried with paper points and obturated by laterally condensed gutta percha (Roeko, Germany) and AH 26 (Densply, Germany) root canal sealer (Figure 4).
PMC2647961_02
A picture of access cavity showing the triangular settlement of the three canal orifices.
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The tooth was isolated and access cavity was modified with a cut at the bucco-proximo angle from the entrance of the buccal canals to the cavo-surface angle resulting in a cavity with a T-shaped outline as described by Balleri et al (Figure 5).
Radiographical confirmation of three root canals and determination of the working lengths.
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The working lengths were estimated using an apex locator and then confirmed with a radiograph (Figure 6).
Periapical radiograph after obturation of the three root canals.
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The canals were dried with paper points and obturated by laterally condensed gutta percha and AH 26 root canal sealer (Figure 7).