Mandibular canine with two root canals

 

In our clinical practise, we often assume a canine to have one root and one root canal. So was my assumption but my habit of critically evaluating the preoperative radiograph has helped to predict the presence of 2 root canals in the present case. On a literature search, I have realised that the occurrence of 2 canals is as high as 12% in some populations and it was about 3.2% in the Indian population. This made me realise how often we might be missing out on these extra canals which might later cause treatment failure. 

On examining the preoperative radiograph 2 root canals were seen joining at the apex. It shows a typical Vertucci type II canal system. we went ahead with access opening which was made in a buccolingual direction similar to maxillary premolar. the simple logic here is that the canine roots are broader on the buccolingual direction and that facilitates extra canals.

The canals were slowly negotiated with a 10 size K file and working length was determined and cleaning and shaping and obturation was done.

TAKE AWAY MESSAGE:

 1) always evaluate preoperative radiographs.

2) good knowledge of anatomy can help preserve tooth structure

3) case planning makes or breaks the day.

References:

1)     Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 1984 Nov 1;58(5):589-99.

2)     Amardeep NS, Raghu S, Natanasabapathy V. Root canal morphology of permanent maxillary and mandibular canines in Indian population using cone beam computed tomography. Anatomy Research International. 2014;2014.

for further reading you can refer to: 

3) Morphologic Aberrations Of Mandibular Canine- Two Root Canals: Case Report. European Journal of Molecular & Clinical Medicine, 2020; 7(5): 1225-1228.