Where is a maxillary first premolar likely to be perforated during endodontic therapy?

The maxillary first premolar is anatomically structured in a way that predisposes its mesial aspect to potential perforation during endodontic therapy. This is due to the positioning of the root canal system, which often has a more pronounced curvature or anatomical variation in this area. The mesial root surface is also close to the buccal and lingual canals, and as practitioners navigate through the canals, there is a greater risk of inadvertently moving beyond the confines of the root structure at the mesial location.

During endodontic treatment, the use of instruments can create a chance for perforation, especially if the operator is not aware of the specific anatomy of the maxillary first premolar. Proper access cavity design is vital to minimize such risks, making it crucial for the dental professional to understand these anatomical nuances.

In contrast, perforations are less commonly associated with the distal, buccal, or lingual aspects of the maxillary first premolar due to the anatomical positioning and root curvature variations that protect those surfaces more effectively during treatment. Therefore, the mesial aspect is acknowledged as the area with the highest likelihood of perforation during endodontic interventions.