Root canal treatment in mandibular canines with two roots: a review of the literature and a report of three cases

Abstract

Endodontic treatment may sometimes fail because the morphological features of the tooth can adversely affect the treatment procedures. Mandibular canines can present with complex internal anatomy and many investigators have reported associated anatomical variations. This paper describes three clinical case reports of mandibular canines, each with two roots and two canals. In addition, the prevalence, aetiology, root morphology and the clinical and radiographic diagnoses for mandibular canines that present with this anatomical variation will be discussed. Root canal treatment on a tooth is performed with the intention of eliminating any infection and preventing the possibility of re-infection in the root canal system. 1 The configuration of the root canals of any tooth can be complex and when treatment fails to locate, clean, shape and obturate them effectively, complications can arise. These include post-operative pain and disease in the affected tooth and surrounding structures. 1-3 Numerous factors can contribute to the failure of endodontic treatment and may include persistent infection in the root canal (which was not eliminated at the initial treatment phase), inadequate approach to cleaning and shaping (leading to poor root canal preparation), broken instruments and incomplete obturation of the prepared root canal. 4 A further variation includes the mandibular canine with two roots and two root canals, having an incidence of up to 12.08%. 8,15-17 Another rare configuration was reported by Heling and co-workers, who treated a mandibular canine with two roots and three canals. 14

Mandibular Canine with Two Canals: A Case Report in Saudi Arabia

“…International studies reported 5 -15% of mandibular canines to have two canals [9-11, 13, 20]. Different root canal configurations were reported in Saudi population [5,[14][15][16]. Recently, Aldahman et al performed a CBCT anatomical assessment of mandibular canines in Saudi population.…”

“…Only one published study reported the incidence of 2 canals in Saudi population (Al-Dahman et al). Few Case reports were found in the literature about clinical cases with 2 canals [5,[14][15][16]. In the current report, a clinical case was presented about successful endodontic management of mandibular canine with 2 canals in Saudi female, in order to add to the current knowledge about root canal morphology in Saudi population.…”