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Introduction: Thorough knowledge of the teeth's root and root canal morphology is vital before obtaining access to endodontic therapy. This study aimed to undertake a comprehensive literature review of the root and root canal anatomy of the mandibular premolars in several provinces of Saudi Arabia. Materials and Methods: The PubMed and Scopus databases were screened for relevant literature. Included studies reported data on the number of roots, root canals, canal configurations, and anatomical variations of mandibular premolars in the Saudi population. Gender morphological differences and bilateral symmetry have also been reviewed, along with case reports of anomalies. Results: Fifteen studies that fulfilled the inclusion criteria were included. The weighted average of single-rooted teeth is 91.4% of the mandibular first premolar and 96.7% of the second premolar. Studies of the internal canal morphology revealed that two or more canals were found in 21.5% of the first premolar and 7.1% of the second premolar. Type I Vertucci canal configuration is the most prevalent in mandibular premolars. The multi-rooted or multi-canalled system variants were frequently reported in the clinical case reports. Conclusion: Mandibular first premolars have a higher incidence of multi-canal system than second premolars, hence clinicians should be attentive to the possibility of an extra canal in these teeth. Few studies are available that discuss the root canal morphology of mandibular premolars in the Saudi population, and further studies with a larger sample size covering Saudi Arabia's provinces are indicated. [ABSTRACT FROM AUTHOR]

Introduction: Cone-beam computed tomography (CBCT) is a recent advancement in diagnostic radiology in dentistry which allows the clinician to have a clear 3D view of the root canals before starting the endodontic treatment. The goal of the present research was to assess the root canal cross-sectional shape (RCCSS) in maxillary and mandibular premolars in the Saudi Arabian subpopulation. Materials and Methods: In the present study, radiographs of 330 patients who had teeth with complete root development and closed apices were selected. Root canal shapes were assessed at the coronal and middle thirds, and in the apical third, 1 mm above the apical foramen using CBCT. Categorical variables were explained as frequencies and percentages and evaluated using the Chi-square test. Results: 1666 premolars were evaluated in the study. Maxillary first and second premolars were found to have a maximum circular cross-sectional shape at the coronal, middle, and apical sections in most of them followed by flattened and oval cross-sectional shapes except the maxillary right second premolars where the most frequent RCCSS was flattened in the coronal section (71%), circular in the middle (14%), and apical (10%) section. The most recurring coronal RCCSS in mandibular first and second premolars was oval followed by flattened and circular, while the most frequent cross-sectional shape in the middle and apical sections was found to be circular followed by oval and flattened RCCSS. Conclusion: Marked variations were observed in the coronal and middle RCCSS of maxillary and mandibular premolars though the most prominent RCCSS in the apical section was the circular shape.

Knowledge of the normal root canal morphology and its variation is essential to ensure a successful root canal therapy. The aim of this report is to describe the endodontic treatment of two mandibular premolars with aberrant root canal morphology with the aid of dental operating microscope. A 29-year-old Saudi male with three mandibular left premolars was referred by the Prosthodontic Department for endodontic evaluation prior to placement of final coronal restorations. The first premolar was diagnosed as having necrotic pulp while the third premolar was previously treated. Root canal treatment and nonsurgical root canal retreatment were performed for the first and third premolars, respectively. The first premolar had a C-shaped configuration and Vertucci′s Type V (1-2) canal system while the third premolar had Type III configuration (1-2-1). One year later, the teeth were asymptomatic with normal periapical tissues radiographically. Root canal aberrations may occur in any tooth type, and the clinicians should always assume the presence of these aberrations and use all the available tools to detect and manage them.

Objectives: This article investigates the internal and external morphological variability of mandibular premolars along with clinical and radiographical signs that leads to early identification of these cases. Materials and Methods: The authors identified articles by searching the PubMed, Medline and Scopus databases. Inclusion criteria were case reports of mandibular premolars with aberrant internal and external anatomy, articles that describe the origin of anatomy of mandibular premolars, the traits that may influence their external and internal variability through species revolution and articles of new technologies like cone beam computed tomography that help the diagnosis of difficult cases. Results: In the majority of the cases, mandibular premolars are reported to have one root canal running a single root. On the other hand, anatomic irregularities in this group of teeth, such as the existence of more than one root or more than one root canals or even a more complicated root canal system cannot be considered infrequent as it appears in 10-25% of the cases. Conclusion: Successful endodontic treatment of mandibular premolars is a challenge for the clinician as they often present morphological and anatomical abnormalities.