Hidden Canal in Mandibular Second Premolar – True Trifurcation Revealed Under the Microscope

Case Summary Mandibular second premolars commonly present with a single canal. However, anatomical variations are well documented in the literature, including root bifurcation and true trifurcation. The incidence of three separate canals in this tooth is considered rare and may not be visible radiographically due to root superimposition. In this case, the pre-operative radiograph did not clearly suggest the presence of an additional root canal. The split became evident only after careful microsurgical inspection of the pulpal floor under magnification, where three separate canal orifices were identified. Diagnosis Tooth #35 Symptomatic irreversible pulpitis Treatment Plan Non-surgical root canal therapy Clinical Procedures Access and Canal Location Access cavity prepared under magnification Three distinct canal orifices located Shaping Rotary instrumentation using Plex-V…