Five root canals in peg lateral incisor with dens invaginatus: A case report with new nomenclature for the five canals

Abstract

This case report describes endodontic treatment completed in a peg-shaped maxillary lateral incisor, with single root and five root canals of which, one is due to dens invaginatus. Cone beam computed tomogram scanning confirmed the unique morphology of the tooth. New nomenclature for the five canals is proposed.

Case Report: Combined nonsurgical and surgical therapy of dens invaginatus of a microdontic maxillary lateral incisor

“…Among treatment options for DI, the operator might opt for a restoration of the defect, nonsurgical endodontic or surgical treatment, or extraction 3 . Morphological changes in the root canal may be associated with the invagination itself 1,4 . Based on radiographic observation, the depth of invagination and connection with periodontal ligament or periapical tissues, Oehlers classified DI into three categories.…”

“…Our web search (Table 1), revealed more instances of case reports concerning microdontia combined with DI in peg-lateral maxillary incisors. One described a tooth with three patent canals to the apical foramen; in another case report, the peg-lateral had five canals with the same pathway to the foramen 4,8 . Treatment modalities varied according to clinical conditions: conventional endodontics alone, conventional endodontics followed by surgical treatment, and conventional endodontics with pulp revascularization.…”

Two Rooted Maxillary Lateral Incisor

“…(1-3)However, morphological variations for these teeth include the presence of two, [4,5]three, [6,7] four, [8] and even five canals, [9] usually associated with the occurrence of t r a u m a t i c s t i m u l i d u r i n g t o o t h d e v e l o p m e n t process. [10]Other morphological variations have also been reported such as dens invagination, [9,11] radicular groove, [12] and fusion. [13] The clinician should always be aware of the possible anatomical variations of the teeth and try to judge their location, length and relationship to one another accurately.…”

Endodontic management and follow-up of two rooted maxillary lateral incisor with open apex – A case report

“…2 Maxillary lateral incisors normally have a single root and single canal. 3 However, morphological variations for these teeth include the presence of two 4,5 three 6,7 four 8 and even five canals 9 usually associated with the occurrence of traumatic stimuli during tooth development process 10 . Other morphological variations such as dens invagination 9,11 radicular groove 12 and fusion, 13 germination 14 are also associated with the maxillary lateral incisors.…”