CASE REPORT Endodontic Treatment of Unusual Central Incisors Hale Cimilli, PhD, and Nevin Kartal, PhD This report presents an endodontic therapy in an unusual case of a patient who had wide crowns of both permanent maxillary central incisors. The right maxillary central incisor had two separate canals on a fused root and the left had a large root canal within one root. Disturbances during morphodifferentiation of tooth germs are rare in the permanent dentition (1– 4). However, there are a few case reports describing endodontic treatment of such teeth in the liter- ature (1, 5–9). This report describes endodontic therapy in an unusual case of a patient who had two unusual maxillary central incisors. CASE REPORT A 17-year-old male patient, having orthodontic therapy that involved the reduction of his central incisors’ diameter to the proper size to allow aligning of his maxillary dental arch, was referred for endodontic therapy. Clinical examination revealed vertical furrows on the buccal and palatinal surfaces of the incisors (Fig. 1). Radiographic examina- tion showed that the right permanent maxillary central incisor had two separate canals with two fused roots and the left had one large root canal with a single root (Fig. 2). The patient had the normal number of teeth in the dental arch. The incisors were anesthetized and isolated with rubber dam. After endodontic access preparations, pulp tissues were removed and the canals were instrumented and shaped with K-files (Zip- perer, Mu ¨ nchen, Germany). The coronal portions of the root canals were flared with a series of Gates Glidden burs (Maillefer, Bal- laigues, Switzerland). Biomechanical preparations were completed with a step-back technique and irrigation with copious amounts of 5.25% sodium hypochlorite solution. The right permanent maxil- FIG 1. Clinical appearance of the teeth. FIG 2. Preoperative radiograph of tooth 8 and tooth 9. JOURNAL OF ENDODONTICS Printed in U.S.A. Copyright © 2002 by The American Association of Endodontists VOL. 28, NO. 6, JUNE 2002 480