(TC37) Identify and Manage Three Root Canal Maxillary Premolars

Abstract: Maxillary premolars, known for their diverse canal morphologies, present challenges; approximately 9% have one canal, 90% exhibit two canals, and 1-2% feature three canals, according to one study. The three-canal configuration comprises a distobuccal canal (DB), a mesiobuccal canal (MB), and a palatal canal, typically with a greater volume in the MB canal relative to the DB. Identifying orifices becomes intricate due to the apical nature of canals and substantial distances between the pulp horn and buccal root bifurcation, sometimes up to 8 mm. Treatment planning is essential for better outcomes in managing these cases. It begins by establishing the premolar's morphology, using multiple off-angle radiographs or cone beam computed technology. Once canals are identified, a tailored management approach can be developed and implemented. This study aims to present a series of five cases demonstrating the use of a modified T-shaped access in the predictable treatment of three-canal maxillary premolars, including pre-, post-operative, and follow-up radiographs.