Iranian Endodontic Journal

Abstract

This case report presents the endodontic management of a hypertaurodontic mandibular second premolar with five root canals, a rare and complex anatomical variation. A 12-year-old male patient presented with a previously treated tooth (history of pulpotomy) with symptomatic apical periodontitis and necrotic pulp. Initial periapical radiographs suggested taurodontism, but cone‑beam computed tomography (CBCT) revealed the presence of five canals merging into four distinct apices. Under CBCT guidance, all canals were negotiated, cleaned, and shaped. An apical barrier was created with bioceramic material, followed by obturation using warm vertical condensation with resin‑based sealer. At the six‑month follow‑up, the tooth was asymptomatic and radiographically satisfactory. This case highlights the diagnostic indispensability of CBCT in detecting intricate root canal configurations in taurodontic teeth and outlines a structured clinical protocol for managing such challenging anatomies.