When a Premolar Plays Tricks: Managing a Rotated Root

Tooth #13 presented with symptomatic irreversible pulpitis but no periapical involvement. Despite appearing normal after a well-executed bridge restoration, CBCT revealed the premolar was significantly rotated, with roots canted in opposite directions. This hidden anatomy made access and canal location especially challenging.

In this video, you’ll see how careful planning, unconventional rubber dam isolation, and CBCT guidance helped manage the rotated roots. The case highlights strategies for maintaining access accuracy, recognizing file fatigue, and achieving predictable shaping and obturation in complex anatomy.