case_images: PMC11286316_01
case_images: The treatment process of maxillary left first premolar tooth ((A-C) preoperative, (D-I) intraoperative, (J, K) postoperative). (A-C) CBCT images represent 3 root configurations, showing apical section from left to right and two sagittal screenings of buccal and lingual root of maxillary left first premolar teeth; (D) diagnostic periapical radiograph; (E) root canal orifice photograph under microscope; (F) 3 root canal diagnostic periapical radiograph; (G) intraoperative tip film; (H) root canal test tip under microscope; (I) root filling film; (J) palatal root postfilm; (K) periapical radiograph 6 months after full crown restoration.
case_images: CRID2024-5525349.001.jpg
case_images: PMC11286316_01_CRID2024-5525349.001.jpg
case_images: fig1
case_images: Furthermore, diagnostic wire images were photographed for another maxillary left first premolar (Figure 1(D)). When the dentin canals of the isthmus were repaired under the microscope, two root canals, namely, the proximal buccal and distal buccal root canals, were observed a few millimeters away from the original buccal root canal (Figure 1(E)). In order to determine the shape of the root canal, a diagnostic X-ray film (Figure 1(F)) was inserted to reveal the presence of three root canals. To further confirm the findings, we extracted a CBCT of the maxillary left first premolar, showing the screenshots of the apical section and the sagittal plane of the mesiobuccal and distal roots of maxillary left first premolar teeth (Figure 1(C)), clearly illustrating the presence of 3 roots in maxillary left first premolar teeth. The postoperative X-ray showed that all the 3 canals were filled (Figures 1(G) and 1(H)). After filling, the surgical microscope revealed two root canal orifices on the buccal side and one on the palatal side (Figure 1(I)). After the clinical examination by the restorative dentist, no tooth discomfort was found, and postcrown restoration was carried out(Figure 1(J)). The reexamination on October 27, 2023, showed that 6 months after the restoration with all-ceramic crowns on maxillary left first premolar teeth (Figure 1(K)), the apical bone mineral density was good, with no obvious low-density image, and the outcome of the root canal therapy was ideal.