Diversity of root canal morphology in mandibular premolars and its treatment strategies

Abstract

Variations in root and canal configurations can be observed in every tooth group. Mandibular premolars are a group of teeth where deviations in the root canal anatomy are common and are among the most difficult to treat endodontically. Diagnosis of root canal anomalies before endodontic treatment is a basic requirement. The root number and canal configurations aberrations such as double canal, C-shaped root canal system, 3-, 4-, and 5-canal are observed in mandibular premolars. There are relationships between some coronal and radicular features and multiple canal anatomy in mandibular premolars. There are significant correlations between external root morphologies and internal root canal systems of the mandibular premolars. Similarly, root characteristics may be related to some coronal features. This comprehensive review aims to examine the morphological variations observed in mandibular premolars and discuss the clinical and radiographic signs in the diagnosis of teeth with complex root canal systems before endodontic treatments.