Endodontic Management of Maxillary First Premolar with S-Shaped Canals.

Abstract: - Root canal systems often have complex anatomy and pose various challenges to every clinician. Research into the morphology of the pulp has revealed that the dental pulp takes many intricate shapes and configurations before reaching the tooth apex like gradual curve, sickle-shaped curve, severe-moderate-straight curve, apical curve, bayonet / S-shaped curve and dilacerated curve, canals emerging as separate but meeting at single apex etc. Among these the ‘S’ shaped or bayonet shaped root canal are most difficult to treat. The unique morphology of dilacerated and S-shaped root canals often pose utmost challenges in negotiation, biomechanical preparation and even obturation of root canal.  Common causes of failures in such cases are primarily related to procedural errors such as ledges, zip and elbow creations, root perforations, fractured instruments and canal blockages with dentinal debris. As clinician, one should have a thorough knowledge and insight of the morphology of root canal related to its shape, form and configuration and effective management strategies before commencing treatment of such cases to render the finest possible treatment. This case report discusses successful endodontic treatment of a maxillary left first premolar (24) with an S-shaped root canal with six months follow up.