Imaging Sci Dent.  2013 Jun;43(2):123-128. 10.5624/isd.2013.43.2.123.

Mandibular lateral incisor with four root canals: A unique case of double tooth diagnosed using multidetector computed tomography

• Gupta SK
• Gupta J
• Acharya SR
• Ather A

• KMID: 1974440
• DOI: http://doi.org/10.5624/isd.2013.43.2.123

Abstract

Double tooth is a dental anomaly consequent to fusion of two or more teeth or gemination of a single tooth. This report describes a unique case of double tooth in relation to a mandibular lateral incisor exhibiting the presence of four root canals. The role of conventional radiography and advanced three-dimensional imaging techniques in the better assessment of complex root canal systems and their aid in endodontic management has also been highlighted.

Keyword

Fused Teeth; Multidetector Computed Tomography; Radiography; Tooth, Supernumerary

MeSH Terms

Dental Pulp Cavity
Fused Teeth
Imaging, Three-Dimensional
Incisor
Multidetector Computed Tomography
Tooth
Tooth Abnormalities
Tooth, Supernumerary
Tooth Abnormalities

Figure

• 

  Fig. 1 A. Intraoral photograph shows a discolored mandibular left lateral incisor with an increased mesio-distal width. B. Three separate orifices of mesial, middle, and distal canals are seen in the access cavity (arrows).

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  Fig. 2 A. Preoperative intraoral periapical radiograph of the left mandibular lateral incisor shows multiple root canals in a single wide root with diffuse periapical radiolucency. B. The radiograph for working length determination. C. Post-obturation radiograph shows obturation of the distolingual, distobuccal, mesial, and middle canals (arrows). D. 1-year follow up radiograph shows satisfactory healing of the periapical lesion.

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  Fig. 3 A. Three-dimensional reconstruction of mandibular left lateral incisor (labial surface) shows a wide root. B. Three-dimensional reconstruction of the left mandibular lateral incisor shows a wide root with a lingual radicular groove (arrow).

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  Fig. 4 A. Axial CT image shows three canals at the cervical level: large distal, mesial, and middle canals. B. Axial image at the middle third of the root revealing the presence of two distal canals (arrows) and a single mesial canal. C. Axial image shows a narrow isthmus joining the mesial and distal canals.

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  Fig. 5 A. Curved coronal CT image shows a large distal and a mesial canal. B. Curved coronal image reveals three distinct root canals. C. Curved coronal image in which the connection between the root canals is evident.

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  Fig. 6 Sagittal CT images (A, B, and C) show the presence of aberrant root canal morphology and the presence of a large periapical radiolucency.

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  Fig. 7 Diagrammatic representation of the complex root canal morphology, as seen in the present case.

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