Bilateral Occurence of Three Canal Mandibular Premolars

Case Report, Feb. 2008 – Sabala et al. in 1994 reported in the Journal of Endodontics (JOE) that abaerrations in the root canal anatomy are 60% of the time bilateral in occurance. They also mentioned that rarer the aberration, the more common is its bilateral occurance.

Three canal mandibular premolars are a rare occurance. 5% was the highest reported in the literature to date. However, in the Caribbean it is far more common to see this anatomic aberration. Treating three canal mandubular premolars is a lot more challenging than three canal maxillary premolars.

Some of the reasons are, all three canals may exist in a single root form and an operator can be cramped for space to access the trifurcation and instrument safely.

Often times the trifurcation is in the middle to apical third making visibilty , even through the microscope, a difficult proposition. However, tactile feel for the canal spaces will enhance microscope oriented management techniques.

Attached is a rare case of two three canal mandibular first premolars in the same individual. Interestingly, both sides have almost identical anatomic forms and canal configurations.

This case proves the findings of Sabala et al. in 1994 that rare aberrations are usually bilateral in occurance.

Any comments are welcome.