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 Table of Contents  
CASE REPORT
Year : 2019  |  Volume : 11  |  Issue : 6  |  Page : 485-487  

A three-rooted permanent maxillary canine: A rare anatomical variant


Department of Oral and Maxillofacial Surgery, Vinayaka Mission’s Sankarachariyar Dental College, Salem, Tamil Nadu, India

Date of Web Publication28-May-2019

Correspondence Address:
Dr. Saravanan Kandasamy
Department of Oral and Maxillofacial Surgery, Vinayaka Mission’s Sankarachariyar Dental College, Salem, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JPBS.JPBS_292_18

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   Abstract 

Maxillary canines are usually found to be the single-rooted, single-canaled teeth1. Two roots with two root canals are a very rare condition2. Here we report a rare case of anatomic variation of permanent maxillary canine with three roots and three root canals which is first of its kind in the literature.

Keywords: Maxillary permanent canine, root canal anatomy, root canals, three roots


How to cite this article:
Kandasamy S, Balakrishnan N, Chandrasekar M. A three-rooted permanent maxillary canine: A rare anatomical variant. J Pharm Bioall Sci 2019;11, Suppl S2:485-7

How to cite this URL:
Kandasamy S, Balakrishnan N, Chandrasekar M. A three-rooted permanent maxillary canine: A rare anatomical variant. J Pharm Bioall Sci [serial online] 2019 [cited 2019 Jun 18];11, Suppl S2:485-7. Available from: http://www.jpbsonline.org/text.asp?2019/11/6/485/258835




   Introduction Top


Morphological variations in tooth roots play a vital role in the treatment prognosis. The identification of such anatomic variations has often been the challenge for the clinical practitioners. Conventional perception about the corresponding tooth not only affects the outcome of the treatment but also raises the efficiency of the practitioner. So it is imperative to know the variations of the tooth roots and root canals. In this article, we report a rare anatomic variation of three-rooted maxillary canine having three root canals, which is first of its kind in the literature.


   Case Report Top


An 80-year-old man came to the Department of Oral and Maxillofacial Surgery, Vinayaka Mission’s Sankarachariyar Dental College, Tamil Nadu, India, with the complaint of pain and mobility on the upper left front tooth region. The tooth was tender on percussion with adherent calculus having grade II mobility characteristic of localized periodontitis. Local anesthesia 2% Lignox with 1:80,000 was administered as infiltration on both buccal and palatal sides. After checking the subjective and objective numbness, the tooth removal was completed by maxillary anterior forceps. The postextraction instructions were given along with oral analgesics. We found that maxillary canine had three separate roots with three root canals Figure 1A] and B]. We took intraoral periapical radiograph and did access opening to find the number of root canals present [[Figure 1]C and D]. The root canals were found to be three-on-three individual separate roots.
Figure 1: (A) Extracted tooth, (B) extracted tooth (close-up), (C) intraoral periapical radiograph of the extracted tooth, and (D) intraoral periapical radiograph showing three root canals.

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   Discussion Top


Diagnosis and identification of the number of roots are the key factors in the treatment of teeth. Maxillary canines are considered to be single-rooted, single-canal teeth, and two bifid root and three root canals in a permanent canine is a rare condition.[1 In such conditions],[ the pulp canal has the potential of being very complex with branching and divisions throughout the length of the root or sometimes joined at the apex of the root. Vertucci[2] had classified the root canal configurations of human permanent teeth into various types, ranging from single to three separate and distinct canals. Various case reports[3],[4],[5] and studies by Pineda et al[1] and Hulsmann [6] showed the variations of single – two roots with 2 root canals. Grossman et al.[7] and Nelson and Ash[8] also reported the two-rooted maxillary canine. Latest articles reported by Bolla and Kavuri[9] and Mohammed et al.[10] showed the double roots of maxillary anterior teeth with two root canals. But three separated roots with three separate root canals were not reported till now to the best of our knowledge. The roots were identified as mesiobuccal, distobuccal, and palatal one [[Figure 1]A and B]. This patient underwent previous extractions of the other teeth in our department only without any such abnormal variations. He lost all his other teeth because of generalized periodontitis due to severe calculus deposits, and we planned complete dental rehabilitation for him.


   Conclusion Top


This case report is to increase the awareness among general practitioners and consultants on such anatomic variations - aberrations in tooth morphology like maxillary canine having three separate roots. So special focus is necessary to detect (Diagnose) and treat those extra roots and root canals to prevent endodontic failures in day to day practice.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Pineda F, Kuttler Y. Mesiodistal and buccolingual roentgenographic investigation of 7,275 root canals. Oral Surg Oral Med Oral Pathol 1972;33:101-10.  Back to cited text no. 1
    
2.
Vertucci FJ. Root canal anatomy of the human permanent teeth. Oral Surg Oral Med Oral Pathol 1984;58:589-99.  Back to cited text no. 2
    
3.
Barkhordar RA, Nguyen NT. Maxillary canine with two roots. J Endod 1985;11:224-7.  Back to cited text no. 3
    
4.
Weisman MI. A rare occurrence: A bi-rooted upper canine. Aust Endod J 2000;26:119-20.  Back to cited text no. 4
    
5.
Alapati S, Zaatar EI, Shyama M, Al-Zuhair N. Maxillary canine with two root canals. Med Princ Pract 2006;15: 74-6.  Back to cited text no. 5
    
6.
Hulsmann M, Schafer E. Problems in gaining access to the root canal system. In: HulsmannM, SchaferE, editors. Problems in endodontics: Etiology, diagnosis and treatment. 1st ed. Germany: Quintessence Publishing; 2009. p. 145-72.  Back to cited text no. 6
    
7.
Suresh Chandra B, Gopikrishna V. Grossman’s endodontic practice. 13th ed, Chapter 12: Permanant maxillary canine. Netherlands: Wolters Kluwer/Lippincott Williams & Wilkins; 2014; 252-3.  Back to cited text no. 7
    
8.
Nelson SJ, Ash MM. The permanent canine: Maxillary and mandibular canine. In: Wheeler’s dental anatomy, physiology and occlusion, 9th ed. St Louis (MO): Elsevier; 2014. p. 125-32.  Back to cited text no. 8
    
9.
Bolla N, Kavuri SR. Maxillary canine with two root canals. J Conserv Dent 2011;14:80-2.  Back to cited text no. 9
[PUBMED]  [Full text]  
10.
Mohammed NM, Mandorah AO, Alqashqari TA. Maxillary canine with two root canals. Saudi Endod J 2015;5:146-8.  Back to cited text no. 10
  [Full text]  


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