Treatment of two canals in mandibular incisors, canines, and premolars

The success of endodontic therapy depends on a thorough understanding of root canal anatomy and the effective treatment of all canals within the system. Anatomical variations, such as the presence of multiple root canals in mandibular teeth, often lead to treatment failures when undetected. This case report describes the endodontic retreatment of the mandibular teeth from the left first premolar (#34) to the right first premolar (#44), each exhibiting two root canals. A 50-year-old patient presented with persistent pain despite previous treatment. Clinical and radiographic evaluations revealed missed secondary canals and incomplete obturations. The comprehensive treatment approach involved modified access openings, careful canal exploration, biomechanical preparation, and obturation using the lateral condensation technique. Radiographs confirmed successful filling of all canals. Following endodontic therapy, the teeth were restored prosthetically using ceramic crowns to ensure functional and esthetic rehabilitation. This case underscores the importance of recognizing anatomical variations, performing comprehensive access preparations, and employing meticulous diagnostic and treatment techniques. In addition, it highlights the critical role of prosthetic rehabilitation in restoring oral function and esthetics, and the broader implications for public health, by emphasizing the importance of timely and effective treatment in preventing long-term dental complications.