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INTERNATIONAL JOURNAL
OF CURRENT RESEARCH
International Journal of Current Research
Vol. 10, Issue, 08, pp.72356-72358, August, 2018

ISSN: 0975-833X
CASE REPORT

ENDODONTIC TREATMENT OF MAXILLARY CANINE WITH TWO CANALS

*Dr. Bonny Paul,

Paul Dr. Kavita Dube and Dr. Charu Kapur
Department of Conservative Dentistry and Endodontics, Hitkarini Dental College and Hospital, Jabalpur, India

ARTICLE INFO ABSTRACT

Article History: Maxillary canines are as a rule considered being single rooted with a single canal. Few reports of
Received 17th May, 2018 presence of maxillary canines with additional canals have been reported in the literature. This article
Received in revised form describes Endodontic treatment of a maxillary canine with two canals. The literature pertaining to
21st June, 2018 unusual anatomy of maxillary canines has been reviewed.
Accepted 22nd July, 2018
Published online 30th August, 2018

Key Words:
Maxillary Canine, Additional Canal.
Copyright © 2018, Bonny Paul et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original work is properly cited.

Kapur 2018. “Endodontic treatment of maxillary

Citation: Dr. Bonny Paul, Dr. Kavita Dube and Dr. Charu Kapur, axillary canine with two canals”, International Journal
of Current Research, 10, (08), 72356-72358.

A diagnosis of irreversible pulpitis was made and it was

INTRODUCTION
decided to carry out endodontic treatment. An informed
Identification and treatment of the entire root canal system is consent of the patient was taken after which 2 % lignocaine
one of the key factors for successful endodontic treatment. was administered. The concerned tooth was isolated with
Maxillary canines are as a rule considered being single rooted rubber dam and a conventional access cavity was prepared to
with a single canal. However a few cases of two root canals expose the canal orifice. A closer examination revealed two
have been reported in literature (Sabala et al., 1994; Pineda et orifices (Fig 2)) and hence the access cavity was modified to
al., 1972). Failure to locate and treat a canal
cana is the most expose the second orifice which was situated slightly more
causative factor of endodontic failure. The root canal system of palatally. The entire pulp tissue was removed and the working
any tooth always has the possibility of being very complex. length was measured using an apex locater (ROOT ZX:
Maxillary canines with more than a single canal or single root MORITA). Radiograph (Fig 3) confirmed the presence of two
with or without developmental anomalies have been reported
repo in canals which united around 3mm before the aapex (Vertucci,
literature. Hence a thorough knowledge of the entire root canal Type II ). The canal orifices were widened using Gates glidden
anatomy is important for the success of endodontic therapy. drills and biomechanical preparation was carried out using K
The present case reports Endodontic treatment of single rooted flex files (Mani). Irrigation was carried out using 5% percent
maxillary canine with two root canals. sodium hypochlorite and instrumentation was done to ap apical
size of 40. A temporary dressing (Cavit G) was placed and the
patient was recalled after a week. The tooth was asymptomatic
CASE REPORT and hence obturation was planned. The master cones were
selected and confirmed by radiograph (Fig 4). Sealapex
A 55-year-old male patient with a non-contributory
contributory medical (Sybron Endo) wass used as the sealer and obturation was done
history reported to the Department of conservative dentistry by lateral condensation method. A radiograph was taken to
and endodontics with pain in his upper right teeth. Clinical confirm and a temporary dressing (Cavit G) was placed (Fig 5).
examination revealed a deep carious lesion in his maxillary The patient was recalled after a week for full coverage crown.
right canine and a radiograph
ograph confirmed the same with no
periapical lesion (Fig 1). However there was no pain on
percussion. Vitality test (RC Ice, Prime Dental) induced an DISCUSSION
exaggerated response.
The root canal system of any tooth has the potential of being
*Corresponding author: Dr. Bonny Paul, very complex with various bifurcations along the length of the
Department of Conservative Dentistry and Endodontics, Hitkarini Dental root. A lot of studies have been carried out in the last few years
College and Hospital, Jabalpur, India.
related to pulp anatomy.
DOI: https://doi.org/10.24941/ijcr.31864.08.2018
72357 Dr. Bonny Paul et al. Endodontic treatment of maxillary canine with two canals

Figure 4. Master cone radiograph

Figure 1. Preoperative radiograph showing deep carious
lesion in canine

Figure 5. Radiograph showing obturation by lateral condensation

Vertucci (1984), Pineda and Kuttler (1972), Black and Green

Figure 2. Access cavity shoeing 2 orifices
(1956), all in their anatomical studies have mentioned that
maxillary incisors have a single root in 100 % of the cases.
Permanent maxillary canines with type V canal configuration
was reported to be 2.17% and type III canal configuration was
reported to be 4.35% (Pineda and Kuttler, 1972). However
there was no report of type II canal configuration. Sonal bansal
et al. reported a type IV canal configuration in a maxillary
canine (2016). Majority of maxillary canines have a single
canal however, according to Caliskan et al. 1995 4.35% and
Weng et al. 2009 2.3% may have a two distinct root canals
with separate apical foramina. Alapati et al reported a maxillary
canine with type II canal configuration (Alapati et al., 2006).
Ravi SV reported a maxillary canine with type II canal
configuration (Ravi, 2011). Dong- Ryul Shin et al reported a
maxillary canine with two separate root canals( type IV )
(Dong- Ryul Shin et al., 2011). Weisman reported a bi rooted
maxillary canine (Weismann, 2006). The present case shows a
type II canal configuration. Two distinct orifices were found in
labial and palatal configuration. The palatal canal eventually
curved and united with the main canal. To locate the additional
Figure 3. Working length radiograph showing two separate canals canals the clinician should be aware of the variations and the
joining in apical 3rd clues that suggest their presence. Also when locating an
72358 International Journal of Current Research, Vol. 10, Issue, 08, pp. 72356-72358, August, 2018

additional canal, periodontal space that often projects onto root Green DA. 1956. A stereomicroscopic study of the root apices
surface resembling a canal should be differentiated (Jaya of 400 maxillary and mandibular teeth. Oral Surg., 1224-
Nagendra Krishna Muppalla et al., 2015). A proper exploration 32.
of the floor of the pulp chamber, with radiographs at different Nakata K, Naitoh M, Izumi M, Inamoto K, Ariji E, Nakamura
angles can help in location of additional canals. Most of the H. 2006. Effectiveness of dental computed tomography in
above reported studies were done by radiographs. Their main diagnostic imaging of periradicular lesion of each root of a
limitation was a 2 dimensional image of a 3 D object. CBCT multirooted tooth ; A case report. J Endod., 32;583-7.
(Neelakantan et al., 2010), Spiral CT (Subha et al., 2013) and Neelakantan P, Subbarao C, Subbarao CV. 2010. Comparitive
3D Acciutomo XYZ Slice View tomography (Nakata et al., evaluation of modified canal staining and clearing
2016) are other methods to view and study root canal anatomy. technique, cone beam computed tomography, peripheral
quantitive computed tomography, spiral computed
Conclusion tomography and plain and contrast medium- enhanced
digital radiography in studying root canl morphology. J
This case report presents an unusual root canal anatomy in a Endod., 36: 1547-51.
maxillary canine. It emphasizes on the importance of the Pineda F, Kuttler Y. 1972. Mesiodistal and buccolingual
fundamental knowledge of root canal anatomy, their variations, roentgenographic investigation of 7275 root canals. Oral
interpretation of radiographs and implementation of modern Surg Oral Med Oral pathol., 33:101-110.
techniques for successful endodontic treatment. This report is Ravi SV, Simon E, Thomas K, Ravi A. 2011. Maxillary canine
presented mainly to increase the awareness in clinicians that with two root canals: A case report. Indian journal of
variation also exist in the anterior tooth group. dental research and review, 69-71.
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