ORIGINAL RESEARCH Journal of Case Reports in Dental Medicine (J Case Rep Dent Med) May 2020, Volume 2, Number 2: 36-39 36 http://jcrdm.org © 2019 JCRDM. Published by Faculty of Dentistry, Hasanuddin University. All rights reserved. Objective: Very long teeth present challenging in endodontic treat- ment. It necessitates modification of the instruments and techniques to negotiate the canal and to obturate to the full working length. This case aims to perform root canal treatment (RCT) of a lengthy maxillary canine of 37 mm length. Methods: A 75-year old man came for a filling of decayed upper front teeth. Radiographically, the right canine showed an abnormality in length. Clinically, it was carious, not tender to percussion, and diagnosed as asymptomatic irrever- sible pulpitis with normal apical tissues. Results: This case illustrated the use of hand H-files (ISO) with the removal of the plastic cable and preparation of the canal by push - pull movement and obturation conventionally through vertical and lateral condensation techniques. CBCT was used to assess treatment outcome. Conclusion: RCT of a very long tooth can be performed by instrument cable removal technique (ICRT) to achieve good quality and better outcomes. Keywords: CBCT, Hand H-file, Lengthy Root Canals, Maxillary cuspid Cite this Article: Hussain S E, Awooda EM. 2020. Root canal treatment for a lengthy maxillary canine of 37 mm. Case Report. Journal of Case Reports in Dental Medicine. 2(2): 36-39. DOI: 10.20956/jcrdm.v2i2.108 Root canal treatment for a lengthy maxillary canine of 37 mm. Case Report Shahad E. Hussain 1 , Elhadi M. Awooda 1* Abstract Introduction The outcomes of the root canal treatment depend on the technical quality and rigorous allied of the principles and procedure to achieve the objectives of cleaning, shaping, and obturation. Good knowledge of the root canal morphology and its variations is crucial. The clinician should have a thorough understanding of the detailed anatomy of the root canal to be able to utilize the most appropriate treatment techniques and protocols, thereby increasing the percentage of success rate. 1 From the literature; a number of studies and case reports have investigated the length of human maxillary canine. In 1902, G.V Black stated that the longest maxillary cuspid was 32.0 mm, 2 while Bjorndal et al. reported the longest maxillary canine at 33.3 mm in 1974. 3 In 1979, Wiene reported a surgically extracted human maxillary canine of 39.5- mm length. 4 While in 1982, Gray came up with an extracted upper canine of 41-mm. 5 Also, a maxillary canine length of 47-mm has been reported. 6 Extremely long maxillary canines present challenges when an RCT is indicated, especially during canal preparation. Endodontic instrument consists of cable and body (intermediate and active part) and the longest file available is 31- mm length. 7 Only a few authors have experienced endodontic treatment of long maxillary canine. 7-12 Although it is very rare to face such critical situation, an unusual mechanical alteration and modification of the instruments and techniques should be implemented to achieve the objectives of RCT. Our aim of this case report was to accomplish biomechanical preparation and obturation of a very long maxillary canine of a 37-mm length and to discuss the treatment modifications that must be considered to successfully manage such very rare cases. Case Report A 75-year-old Sudanese man with no significant past medical history was presented with a chief complaint of multiple decayed teeth and food impaction on the upper right canine. Visually, the intra-oral clinical examination revealed dental caries on all upper anterior teeth. The tooth of. chief complaint showed mesial proximal dental caries. It responded negatively to cold sensibility test, without tenderness to vertical or horizontal percussion, and its crown width and length were within the average normal dimension of maxillary canines with slight attrition of up to 1mm. Normal physiological mobility and no swelling or palpation on the soft tissues over the apex area. Soft tissues examination revealed marginal gingivitis of all anterior teeth with normal pocket depth, and extra- oral examination no abnormality detected. Intra oral periapical radiographic for the tooth of complaint (#13) showed abnormal length of 37 mm figure 1. University of Medical Sciences and Technology, Sudan * Correspondence to: sowaraldahb@gmail.com Received: 6 December 2018 Revised: 20 January 2019 Accepted: 25 March 2019 Available Online: 1 May 2020