Conventional root canal treatment of a mandibular second premolar with three roots and three canals performed by an undergraduate student: A case report with 8-year follow-up

Abstract

In developing countries, such as Sudan, there is a lack of advanced endodontic technologies and specialized endodontists. Therefore, challenging endodontic cases are inevitability encountered by undergraduate students and general dental practitioners. Their ability to manage such cases can significantly impact the decision of whether a tooth is saved or extracted. Here, we report the case of a 24-year-old male patient who presented to our clinic with pain in the mandibular second premolar. Tooth #45 had caries and was tender to vertical percussion. An intraoral periapical radiograph (IOPR) revealed a wide periodontal ligament space and thickened lamina dura, with the deep occluso-distal decay reaching the pulp space. A radiograph obtained using the tube shift technique revealed the presence of three distinct roots and canals. The patient was diagnosed with symptomatic irreversible pulpitis and apical periodontitis. His root canal treatment (RCT) was performed by a 5th-year undergraduate student using the conventional radiography technique, hand file instruments, and lateral condensation obturation. At the 8-year follow-up visit, the tooth crown was lost, the patient was asymptomatic, and the IOPR revealed normal periapical bone. This case demonstrates the importance of training undergraduate students from developing countries to perform RCT for challenging endodontic cases using conventional techniques.

Keywords

• anatomic variation
• dental student
• follow-up
• mandibular bicuspid
• root canal therapy