(TC34) C-shaped Root Canals in Mandibular Premolars: a Mini-Review and Case Report

Due to their complex anatomy, C-shaped canals present a unique and difficult challenge for endodontic treatment. Abnormal development of Hertwig’s epithelial root sheath can cause C-shaped canals to form, which require more cautious treatment because of atypical anatomy. Instrumentation and obturation become far more complicated in these cases. In this review, studies regarding mandibular first and second premolars are assessed in incidence of C-shaped canal anatomy. Clinical cases are also observed to review treatment outcomes and emphasize the importance of accurate diagnosis and treatment planning. In most cases, advanced instrumentation and obturation techniques, as well as specialized imaging modalities are utilized to aid in treating these canals. Increased irrigation with sodium hypochlorite and ultrasonic instrumentation is imperative to prevent re-infection of the anatomically complex canals. The critical nature of imaging techniques, such as the use of cone-beam computed tomography (CBCT), is highlighted to demonstrate its value for analyzing these anatomical root configurations. In some cases when conventional root canal treatment methods may not be as practical or successful, apicoectomy and retrofilling may be required to completely remove infected material. By assessing the implications and outcomes of treating C-shaped canals in mandibular premolars, this review is aiming to provide a detailed understanding of diagnosis and treatment of these cases to improve clinical outcomes.