Mancino Davide, Kharouf Naji
Chin J Dent Res. 2019;22(2):139-143. doi: 10.3290/j.cjdr.a42518.
Mandibular canines are usually considered to be single-canal teeth. However, more than one canal and, more rarely, two roots may also occur. Three clinical cases are reported in order to illustrate endodontic anatomical variants in the human mandibular canine. All procedures were performed in conformity with the current state-of-the-art practices in endodontics, which included effective local anaesthesia, rigorous clinical and radiographic pre-access analysis, appropriate tooth restoration to ensure watertight rubber dam installation and surgical microscopic manipulations for precision. The first case involved a mandibular canine with only one root but two canals, including a lateral canal. The second case was a retreatment of a mandibular canine with two roots, two canals and a broken stainless steel K-File in the buccal canal. The third case involved a mandibular canine that revealed a rare root canal configuration (1-3-1): a Sert and Bayirli's type XVII canal. To avoid missing the presence of any root canals in endodontic treatment, clinicians should have a thorough knowledge of the anatomic variants of the root canal system and should take the necessary time to perform a rigorous pre-access analysis. The systematic use of a surgical microscope and ultrasonic endodontic tips facilitates and standardises access cavity preparation and canal localisation.
下颌尖牙通常被认为是单根管牙。然而，也可能出现不止一个根管，更罕见的是两个牙根。报告了三例临床病例，以说明人类下颌尖牙的牙髓解剖变异。所有操作均按照当前牙髓病学的先进实践进行，包括有效的局部麻醉、严格的临床和影像学术前分析、适当的牙齿修复以确保安装水密橡皮障以及使用手术显微镜进行精确操作。第一例涉及一颗只有一个牙根但有两个根管（包括一个侧支根管）的下颌尖牙。第二例是对一颗有两个牙根、两个根管且颊侧根管内有一根折断的不锈钢K锉的下颌尖牙进行再治疗。第三例涉及一颗下颌尖牙，其显示出一种罕见的根管形态（1-3-1）：塞尔特和巴伊里的十七型根管。为避免在牙髓治疗中遗漏任何根管，临床医生应全面了解根管系统的解剖变异，并应花必要的时间进行严格的术前分析。系统使用手术显微镜和超声牙髓治疗尖有助于并规范开髓洞形制备和根管定位。
