Endodontic reintervention of a mandibular second premolar with four root canals: a case report

Complex anatomical variations on root canals morphology are one of the most arduous challenges in endodontic practice. The objective this case report is to discuss clinical management a mandibular left second premolar with four and distinct apical foramina. This has been written according Preferred Reporting Items for Case reports Endodontics (PRICE) 2020 guidelines. A 74-year-old patient was referred retreat premolar. complained discomfort when chewing hard food. After obtaining consent from investigate symptoms, thorough radiographic examination performed. main findings observed were moderate sensitivity vertical percussion mild at palpation. periapical radiograph showed fusion-like multiple unsatisfactory canal fillings associated radiolucency. Based investigation, diagnostic persistent periodontitis made tooth, nonsurgical re-treatment proposed patient. informed obtained, procedure performed under magnification provided by dental operating microscope aid ultrasonic tips. During access opening removal, orifices observed. Therefore, state-of-the-art technology such as microscope, ultrasonics, cone-bean computed tomography image strong allies manage variations.