Management of Maxillary Central Incisor with Two Canals - A Case Report

Aim: To report the successful endodontic management of a maxillary central incisor with two root canals thereby emphasizing the importance of accurate diagnosis and treatment planning. Background: Maxillary central incisors typically have a single canal. However, anatomical variations though rare can occur. The presence of two canals poses a diagnostic challenge and if left unrecognized might lead to treatment failure. Advanced imaging techniques like cone-beam computed tomography (CBCT) aids in detecting such variations thereby ensuring effective root canal therapy. Case Description: A 28-year-old male presented with persistent pain in the maxillary right central incisor. Clinical and radiographic examinations revealed deep caries and an additional canal. CBCT confirmed a single root with two canals (Vertucci Type III). The access cavity was modified to locate both canals which were instrumented using rotary NiTi files and irrigated with 2.5% sodium hypochlorite. Obturation was performed using the warm vertical compaction technique followed by post-endodontic restoration. The patient remained asymptomatic at follow-up. Conclusion: Recognizing root canal variations is crucial for treatment success. Multiple angulated radiographic images enhance anatomical assessment thereby ensuring thorough debridement and obturation. Clinical Significance: Failure to identify additional canals may lead to endodontic failure. Multiple angulated radiographic images guided diagnosis improves treatment outcomes.