case_images: PMC10542588_01
case_images: Clinical and radio-graphical presentation of tooth #17. (a) Pre-operative periapical radiograph showing widening of the apical lamina dura associated with the palatal root for tooth #17. (b) Access cavity of tooth #17 under rubber dam isolation, revealing 2 buccal and 2 palatal canal orifices. (c) Post-operative periapical radiograph revealing complete obturation of all canals (mesio-buccal, disto-buccal, mesio-palatal, and disto-palatal canals).
case_images: CCIDE-15-199-g0001.jpg
case_images: PMC10542588_01_CCIDE-15-199-g0001.jpg
case_images: f0001
case_images: However, no anatomical variations were noticed or reported by the referrer dentist (Figure 1a).  Hence, further deroofing of the pulp chamber was carried out under magnification (OPMI PICO; Carl Zeiss, Gottingen, Germany) and a second palatal canal orifice was identified (Figure 1b). The postoperative radiograph revealed two that tooth # 17 possessed 4 canals with completely separate apical course (Figure 1c).
case_images: Post-operative Cone Beam Computed Tomography scan (axial sections) for tooth #17. (a) Coronal root view showing 4 obturated canals. (b) Mid root view showing separate mesio-buccal canal in addition to disto-buccal, mesio-palatal, and disto-palatal canals. (c) Apical root view showing two separate mesio-buccal and disto-buccal roots, and one bifid palatal root encasing two palatal canals.
case_images: CCIDE-15-199-g0002.jpg
case_images: PMC10542588_01_CCIDE-15-199-g0002.jpg
case_images: f0002
case_images: A post-operative "limited field-of- view" CBCT scan was taken to confirm and analyze the unusual anatomy of tooth #17 (Figure 2a-c).