Endodontic management of mandibular canine with two roots and two canals: a rare case report

Abstract

BackgroundIn general, mandibular canines have a single root and a single canal. The occurrence of two roots and two canals is a rare entity ranging from 1 to 5%. The anatomy of root canal morphology plays a decisive role in determining the conditions under which endodontic treatment can be performed effectively. Successful endodontic treatment comprises proper diagnosis, meticulous cleaning and shaping followed by three dimensional obturation. Failure to do so may lead to postoperative diseases, pain and further complications. This paper reports successful management of a mandibular canine with two roots and two canals.Case presentation45-year-old Nepalese women with a non-significant medical history presented with a chief complaint of pain in a lower left front tooth. The pain disturbed her sleep and lingered for several minutes even after removal of a thermal stimulus. Clinical examination and testing revealed generalized severe attrition with tenderness to percussion in the mandibular left canine. Electric pulp test for all the mandibular anteriors revealed almost no response in the mandibular left canine. Intraoral periapical radiographs in different angulations were taken which revealed two roots and two canals. A clinical diagnosis of chronic irreversible pulpitis with symptomatic apical periodontitis was made and root canal therapy was performed following the standard protocols.ConclusionAlthough the prevalence of two roots and two canals in mandibular canine is very low, the clinician should always be mindful of variations in the number of roots and canals for proper management of such cases.

Skeletal Maturity Assessment using Mandibular Canine Calcification Stages

“…5 According to the literature, CVM stages strongly correlate with skeletal maturity but some studies show a weak correlation. 11,18 The relation between left mandibular canine and skeletal maturation in the Pakistani population was 0.787 in this study. As a result, it may be concluded that the mandibular canine is an important factor in determining skeletal maturity.…”

Root Morphology and Canal Configuration of Permanent Canines Among Saudi Population: Systematic Review and Comparison with Worldwide Studies

“…Most other original research studies that investigated the canine has been conducted outside the Saudi population [20][21][22][23][24][25][26][52][53][54][55][56][57][58][59][60] as presented in Table 2. Other papers, such as case report studies, 51,[61][62][63][64][65][66][67] studied the RMCC among Western populations. Therefore, this review aimed to search studies in the form of original research and/or case reports on canine RMCC on the basis of Vertucci's classification 19,34 among Saudis.…”

Demystifying the Complexity: A Case Report on the Management of Mandibular Canine with Two Roots

“…Morphologically, mandibular canines usually have only one root and one root canal in approximately 85% of the cases [7]. However, atypical findings like mandibular canine having one root with two root canals and two roots with two root canals have been reported [6][7][8][9]11]. In fact, a rare case of mandibular canine with two roots and three root canals has been reported by Heling et al [12].…”

“…The mandibular canine has Vertucci's type I configuration in approximately 85% of the cases [3][4][5]. However, cases may present with two canals in a single root or even less commonly, with two roots and two root canals and inadequate knowledge of such anatomical variations is one of the most common causes of endodontic treatment failure [6][7][8][9][10]. A patient presenting with such root canal anatomy is unpredictable, and the clinician should always be recognizant of such variations that may affect the prognosis.…”