Unusual anatomies: case series

Aim: The aim of this article is to describe three case reports of unusual teeth anatomy, more precisely of a maxillary right central incisor with two roots and two root canals, a mandibular premolar with four root canals and a second maxillary molar with five root canals associated with an extra small root located in the center of pulp chamber. Methodology: A correct diagnosis, the awareness of finding an unusual anatomic root variation in any endodontic treatment, the use of technological equipment like the operative microscope and ultrasonic tips enabled the operator to solve the clinical case in a safe and predictable way. In order to set a correct treatment plan, it is quite important to evaluate a pre-operative radiograph before starting the endodontic treatment. Another step is the thorough examination of the pulp chamber floor, better if carried out under magnification and coaxial light in order to easily locate all the canal orifices. The endodontic treatment and retreatment of the previously mentioned three uncommon teeth will be discussed. Results: All the root canals were found, treated and obturated in the three presented cases and healing was shown in the follow up radiographs. Conclusions: Anatomic root variations should be anticipated in order to be encountered in the daily endodontic practice. A pre-operative radiography must always be done before endodontic treatment in order to make the right diagnosis. The operative microscope magnification is useful in order to work in a safe and precise way.