Four cuspal max. 2nd PM with single root and three root cana
Traditional configuration of maxillary second premolars has been described to have two cusps, one root and one or two root canals.

The endodontic literature reports considerable anatomic aberrations in the root canal morphology of maxillary second premolar but the literature available on the variation in cuspal anatomy and its relationship to the root canal anatomy is sparse.

The present case describes the root and root canal configuration of a maxillary second premolar with four cusps. A 23-year-old male patient reported with a chief complaint of decay and food lodgment in relation to his upper left back teeth region for a few months. He also complained of periodic episodes of pain.

Radiographic examination in relation to the same tooth revealed a coronal radiolucency involving enamel, dentin and pulp, suggestive of caries involving pulp, but there were no signs of any periapical pathology. Based on clinical and radiographic features, a diagnosis of asymptomatic irreversible pulpitis was established, and endodontic treatment was planned.

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