A central incisor with 4 independent root canals: a case report

The maxillary central incisor is the tooth with the least anatomic variations. Despite the fact that several studies have reported a prevalence of 100% for the presence of a single canal, root canal aberrations of maxillary central incisors with up to 3 canals have also been reported. Such cases represent both a diagnostic and technical challenge to the clinician. The present case describes root canal treatment performed in a maxillary central incisor with 4 canals. The detection of all canals was achieved by examination of the pulp chamber floor with the help of the dental operating microscope as well as careful examination of intraoral radiographs. The canals were prepared with hand and rotary instruments and obturated with a warm gutta-percha technique. The present report is the first to describe a maxillary central incisor with 4 canals in a tooth with no developmental abnormalities. It stresses the importance of using a dental operating microscope during endodontic treatment as well as questioning the routine use of cone-beam computed tomographic imaging for similar cases.