Retratamiento endodóntico de primer premolar mandibular con anatomía atípica: Reporte de caso

Abstract

Mandibular first premolars have the highest failure rate, approximately 11.45%, in non-surgical endodontic treatment. They are some of the most difficult teeth to treat due to the anatomical variations they may present. This case is of a 46-year-old male patient who underwent non-surgical endodontic retreatment in two sessions. Clinically, tooth 44 presented a disto-occlusal fracture limited to the clinical crown with exposure of endodontic filling material. The patient was not tender to percussion. The periapical radiograph and cone-beam computed tomography revealed an atypical anatomical configuration 2441B1-2L1 according to the classification proposed by Ahmed, and a periapical hypodense image. The diagnosis was previous root canal treatment and asymptomatic apical periodontitis. The procedure was performed using magnification, manual and reciprocating instrumentation, disinfection with ultrasonic irrigant activation, intracanal medication, and filling with a bioceramic sealer and vertical compaction technique.In conclusion, mandibular premolars may present atypical anatomy, which can complicate endodontic treatment and prognosis.