Five root canals in peg lateral incisor with dens invaginatu
This case report, published in the Journal of Conservative Dentistry, describes endodontic treatment completed in a peg-shaped maxillary lateral incisor, with single root and five root canals of which, one is due to dens invaginatus. CBCT scanning confirmed the unique morphology of the tooth. New nomenclature for the five canals is proposed.

The present case is about a 17-year-old male patient who complained of heaviness and pain in relation to the upper front tooth. Clinical evaluation revealed no significant extraoral findings. On intraoral examination, both the MLIs appeared peg-shaped. However, the right lateral incisor was associated with a soft tissue swelling in the labial vestibule, tender on percussion and gave a negative response to electric pulp testing.

Intra oral periapical radiograph of the maxillary right lateral incisor revealed ill-defined periapical radiolucency associated with an unusual canal morphology and DI. Based on the clinical and radiological findings, a diagnosis of acute periapical abscess was made.

Under rubber dam isolation, an access opening was made and an orifice (C1) was visualized after copious amount of purulent discharge was allowed to drain through the C1. The endodontic explorer was placed in the C1 and verified with an apex locator and radiograph. It was found in the canal space corresponding to the DI. However, as the drainage of purulent discharge persisted, a calcium hydroxide intra-canal medicament was placed and access cavity was temporarily sealed.

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