Introduction: Accurate diagnosis of root canal morphology and anatomy is essential for thorough shaping and cleaning of the entire root canal system and consequent successful root canal treatment. In a mandibular second premolar, it is rare to find extra roots and canals. The anatomy of the pulp chamber floor in premolars with more than one canal usually reveals one lingual and two buccal orifices at the same level. Case Presentation: This case report explains nonsurgical endodontic treatment of a mandibular second premolar with three separate canals and three separate mesiobuccal, mesiolingual, and distolingual orifices. Discussion: Mandibular premolars have always proven to be an enigma to endodontist, as they exhibit a high degree of variability in their root canal morphology when compared to any other tooth in the oral cavity. Flat roots are much more likely to contain multiple canals and intercanal ramifications. In such cases, to obtain predictable results, high quality preoperative radiographs should be available at different horizontal angulations and carefully evaluated to detect the presence of extra root canals.

Introduction: Accurate diagnosis of root canal morphology and anatomy is essential for thorough shaping and cleaning of the entire root canal system and consequent successful root canal treatment. In a mandibular second premolar, it is rare to find extra roots and canals. The anatomy of the pulp chamber floor in premolars with more than one canal usually reveals one lingual and two buccal orifices at the same level. Case Presentation: This case report explains nonsurgical endodontic treatment of a mandibular second premolar with three separate canals and three separate mesiobuccal, mesiolingual, and distolingual orifices. Discussion: Mandibular premolars have always proven to be an enigma to endodontist, as they exhibit a high degree of variability in their root canal morphology when compared to any other tooth in the oral cavity. Flat roots are much more likely to contain multiple canals and intercanal ramifications. In such cases, to obtain predictable results, high quality preoperative radiographs should be available at different horizontal angulations and carefully evaluated to detect the presence of extra root canals.