Mandibular Canines with Two Roots and Two Root Canals: Case Report and Literature Review

Abstract

Usually, the mandibular canine only has one root and one root canal. However, there has been a noticeable increment in evidence showing variations in its morphology, such as the presence of two roots and two root canals. The aim of this article was to present a case of a mandibular canine with two roots and two root canals and to review the available literature on this anatomic variation. Root canal treatment of tooth #43 with such morphology was performed in a 47-year-old woman. Careful inspection of the preoperative radiograph indicated the presence of more than one canal. The 12-month follow-up showed normal periapical tissues, with no pain or tenderness. Literature review revealed that the overall prevalence of such root canal configuration is 5.7%, with a strong preference for female sex (87.5%). Although mandibular canines with two roots and two root canals are not common, clinicians should always anticipate the presence of possible variations. Therefore, timely diagnosis and meticulous exploration of such mandibular canines allow for planning of an individualized treatment protocol, tailored to their peculiar morphology, focused on avoiding excessive weakening or even perforation of the roots.

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

“…The complex nature of the root canal system prerequisites the clinician to scrutinize for the presence of any anatomical variation. 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].…”

“…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].…”

“…Cone-beam computed tomography gives accurate detail in axial, sagittal, and coronal planes and is recommended if the diagnosis cannot be made using conventional radiographs [15]. Access opening providing straight-line access to the pulp chamber is recommended for successful endodontic treatment [7]. The anomalous presence of bifurcation at different levels mandates the clinician to perform endodontic procedures with adjunct magnifying aids.…”

“…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.…”

Frequency of Two Roots in Permanent Mandibular Canine of Pakistani Population: A Cone Beam Computerized Tomography (Cbct) Study

“…This is a r e c o g n i z e d a n d d o c u m e n t e d f a c t t h a t mandibular canines can have more than one root canal which clinicians should consider while [2] performing quality endodontic treatment . Few studies show that the existence of two canals and even more two roots is rare, ranging [3] from 1% to 5%…”