Management of mandibular premolars with various C-shaped root canal configurations: A case series

C-shaped canal configuration poses a challenge to the clinician, both at the diagnostic and treatment levels. The present case series aims to describe the management of mandibular premolars that have various C-shaped configurations. Three healthy Saudi females were referred to the endodontic department for the management of premolars that appear unusual radiographically. The teeth response was normal to palpation and percussion. The cold test was negative for the concerned premolars. A diagnosis of either necrosis or previously initiated was established for the pulpal condition. The periapical tissues were diagnosed as normal/asymptomatic apical periodontitis. Modern endodontic tools such as a limited field of view cone-beam computed tomography, the dental operating microscope, and nickel–titanium files were used to negotiate, clean, and shape the root canal system. While EndoActivator sonic irrigant activation was used to effectively disinfect the uninstrumentable ramifications, thermo-plasticized gutta-percha in continuous-wave compaction technique was used to fill the root canal system. During a 12-month follow-up, the clinical and radiographic evaluation revealed no signs and symptoms and periapical healing of the lesion associated with the tooth in case #1. The other premolars were also free of signs and symptoms, with normal apical tissues.