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18 I I case report _ challenging RCTs _Every endodontist knows that each tooth is different and has to be treated with care, paying attention to detail. There are various studies on root- canal anatomy, the configuration of canal orifices and the canals themselves.1 Several scientific articles discuss the presence of additional canals in maxillary first premolars and mandibular first molars. The percentage of additional root canals varies between 0 and 6% for the maxillary first molar and between6and23%forthemandibularfirstmolar.1–6 The root-canal treatment (RCT) of these teeth is challenging for every clinician and requires know- ledge, patience and a variety of instruments and devices. _Case I: Three-rooted maxillary first premolar A 34-year-old male patient was referred to our clinic with mild symptoms of pain and soreness owing to chronic apical periodontitis on tooth #5. Thegeneralpractitionerreferredthepatientbecause she was unable to perform the RCT. The preoperative radiographs revealed three separate roots in the first upper right premolar (Figs. 1a–c). The access cavity was modified with a safe-end bur and a Start-X ultrasonic tip #1 (DENTSPLY Maillefer) in order to locatethethirdrootcanal.Thenegotiationofthedis- tobuccalcanalbeganwitha10.04Micro-Openerand a ProTaper SX file (DENTSPLY Maillefer). Negotiation of the canal was facilitated by coronal pre-enlarge- mentusingProTaperS1,S2andSXfiles.Afterpatency had been confirmed with a 08.02 K-file, the working length was determined with the electronic apex locator (iPex, NSK) and a glide path was established using PathFiles (DENTSPLY Maillefer) at 250rpm and maximum torque. All three canals were shaped with ProTaper NiTi instruments. The last instrument used to length was a ProTaper F1 file and then apical gauging was per- formed. The final instruments were a ProTaper F2 file for the mesiobuccal and distobuccal canals and a ProTaper F3 file for the palatal canal. Copious irriga- tion with 5% sodium hypochlorite was performed throughout the RCT. Final irrigation entailed passive ultrasonic irrigation with 5% sodium hypochlorite, followed by ultrasonically activated 40% citric acid. A final rinse was done with 95% ethyl alcohol. Obturation of the root-canal system was done according to the Continuous Wave of Condensation techniquewithAlphaIIandBetadevices(B&LBiotech; roots1_2011 When nature laughs at endodontists: Two case reports Author_ Dr Bojidar Kafelov, Bulgaria Fig. 1a Fig. 1b Fig. 1c Fig. 2