Diagnosis and treatment of a maxillary lateral incisor with two root canals. A case report.

Abstract

Although endodontic treatment has shown high success rates, the factors involved in the failure cases are still being studied. In this sense, the complexity of interradicular anatomy may lead to inadequate instrumentation and the persistence of etiological factors related to apical periodontitis and endodontic failure. The present case report illustrates the occurrence, diagnosis and nonsurgical endodontic treatment of a maxillary lateral incisor with two canals. A 24-year-old Peruvian woman was referred complaining of darkening of the upper front tooth. After clinical examination, the patient was diagnosed with necrotic pulp and asymptomatic apical periodontitis. Still, radiographic examination revealed a disruption in the canal continuity, leading to a suspicion of unusual root canal morphology in the maxillary lateral incisor. By taking radiographs from different angles, according to the technique described by Clark, the presence of two independent canals was verified. Since most cases of endodontic failure are due to untreated canals, a predictable endodontic therapy must achieve the removal and neutralisation of etiologic factors related to periapical infiltration. The occurrence of additional root canals requires a correct interpretation of radiographic images to detect these variants and take the necessary considerations for proper endodontic treatment.