Diagnosis, treatment planning and root canal of a lower first premolar with two canals using 3D computed tomography: Case Report.

Gonzalo Vásquez, Gilda Corsini, Víctor Beltrán


The morphology of the root canal system is highly variable and complex. Therefore, comprehensive knowledge of its anatomy and the planning of the procedure using imaging systems, such as 3D cone beam computed tomography (CBCT), prior to performing endodontic treatment, improve the prognosis, increasing the chances of success. The aim of this report is to show the sequence of a clinical outcome of a lower first premolar (tooth 4.4) with a complex anatomy, using CBTC in diagnosis and planning.


Diagnosis, treatment planning and root canal of a lower first premolar with two canals using 3D computed tomography: Case Report.

RESUMEN. El tratamiento endodóntico debe considerar que los dientes presentan una morfología del sistema de canales radiculares con alta variabilidad y complejidad. Por lo tanto, el conocimiento acabado de la anatomía radicular y la planificación del procedimiento utilizando sistemas imagenológicos previos a la realización del tratamiento endodóntico, como la tomografía computarizada 3D (CBTC), mejoran el pronóstico, aumentando las probabilidades de éxito. El objetivo de este reporte es mostrar la secuencia de una resolución clínica de un primer premolar inferior (diente 4.4) con una anatomía compleja, utilizando el CBTC tanto en el diagnóstico como en la planificación.



Root canal treatment; endodontics; treatment plan; Cone-Beam Computer Tomography. Tratamiento de conducto; endodoncia; plan de tratamiento; Tomografía computarizada de haz cónico.


Yang H, Tian C, Li G, Yang L, Han X, Wang Y. A cone-beam computed tomography study of the root canal morphology of mandibular first premolars and the location of root canal orifices and apical foramina in a Chinese subpopulation. J Endod. 2013;39(4):435–8.

Byun C, Kim C, Cho S, Baek SH, Kim G, Kim SG, Kim SY. Endodontic Treatment of an Anomalous Anterior Tooth with the Aid of a 3-dimensional Printed Physical Tooth Model. J Endod. 2015;41(6):961–5.

Ahmed HMA, Versiani MA, De-Deus G, Dummer PMH. A new system for classifying root and root canal morphology. Int Endod J. 2017;50(8):761–70.

de Freitas JV, Baratto-Filho F, Coelho BS, Tomazinho FSF, Crozeta BM, de Sousa Neto MD, Gabardo MCL. Efficacy of Different Cone-beam Computed Tomographic Protocols in the Identification of Mesiobuccal Canals of Maxillary First Molars: A Tomographic and Ex Vivo Study. J Endod. 2017;43(5):810–5.

Ee J, Fayad MI, Johnson BR. Comparison of endodontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography. J Endod. 2014;40(7):910–6.

Vertucci FJ. Root canal anatomy of the mandibular anterior teeth. J Am Dent Assoc. 1974;89(2):369–71.

Setzer FC, Hinckley N, Kohli MR, Karabucak B. A Survey of Cone-beam Computed Tomographic Use among Endodontic Practitioners in the United States. J Endod. 2017;43(5):699–704.

Verner FS, D'Addazio PS, Campos CN, Devito KL, Almeida SM, Junqueira RB. Influence of Cone-Beam Computed Tomography filters on diagnosis of simulated endodontic complications. Int Endod J. 2017;50(11):1089–96.

Cheung GS, Wei WL, McGrath C. Agreement between periapical radiographs and cone-beam computed tomography for assessment of periapical status of root filled molar teeth. Int Endod J. 2013;46(10):889–95.

Lara-Mendes STO, Barbosa CFM, Machado VC, Santa-Rosa CC. A New Approach for Minimally Invasive Access to Severely Calcified Anterior Teeth Using the Guided Endodontics Technique. J Endod. 2018;44(10):1578–82.

Lara-Mendes STO, Barbosa CFM, Santa-Rosa CC, Machado VC. Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report. J Endod. 2018;44(5):875–9.

Gambarini G, Ropini P, Piasecki L, Costantini R, Carneiro E, Testarelli L, Dummer PMH. A preliminary assessment of a new dedicated endodontic software for use with CBCT images to evaluate the canal complexity of mandibular molars. Int Endod J. 2018;51(3):259–68.

Jain A, Bahuguna R. Root canal morphology of mandibular first premolar in a gujarati population - an in vitro study. Dent Res J. 2011;8(3):118–22.

Velmurugan N, Sandhya R. Root canal morphology of mandibular first premolars in an Indian population: a laboratory study. Int Endod J. 2009;42(1):54–8.

Abraham SB, Gopinath VK. Root canal anatomy of mandibular first premolars in an Emirati subpopulation: A laboratory study. Eur J Dent. 2015;9(4):476–82.

Tabassum S, Khan FR. Failure of endodontic treatment: The usual suspects. Eur J Dent. 2016;10(1):144–7.

Chaurasiya S, Yadav G, Tripathi AM, Dhinsa K. Endodontic Failures and its Management: A Review. Int J Oral Health Med Res. 2016;2(5):144–8.

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