Keywords
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Mandibular canine, Two roots, Cone beam computerized tomography. |
Introduction
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The internal anatomy of the root often does not reproduce the simplicity of the tooth's external anatomy, sometimes presenting multiple variations. Mandibular canines are an example of this, since they present a complex internal anatomy [1]. |
The anatomical variation of two independent roots (vestibular and lingual) each with an independent canal is infrequent and has been described in the literature through case reports [2,3,4]. Another factor which influences the success of endodontic treatment is the appropriate use of imaging techniques as part of diagnosis and treatment planning. Conventional periapical radiography continues to be the most widely-used diagnostic method in clinical endodontics, however the development of CBCT has shown up the deficiencies of conventional radiography for evaluating dental anatomy in three dimensions (3D) [5]. |
The object of the present report is to describe endodontic treatment of an unusual mandibular canine with two independent roots and two canals using CBCT.q |
Case Report
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Male patient, aged 62 years, no relevant clinical history, was referred to the Endodontics Unit of Universidad de La Frontera, Temuco, Chile, for diagnostic and therapeutic evaluation of the left mandibular canine (tooth 33). |
On clinical examination, profound mesial caries was observed, with grade 1 mobility and pain under percussion. The result of sensitivity tests was negative. Initial periapical radiography (Figure 1A), revealed penetrating mesiocervical caries, widening of the periodontal ligament and the presence of two roots and two canals in the mandibular canine, which bifurcated in the middle third of the root. Percussion test was positive. The radiographic study was complemented by periapical radiography with mesial (Figure 1B) and distal distortion (Figure 1C). The endodontic diagnosis for tooth 33 was symptomatic apical periodontitis. |
To obtain more information on the internal anatomy of the canal system, a CBCT examination of the tooth in question was requested (Pax Zenith, Vatech, Korea, 2011). The examination was done with a FOV 8Ã |