#26 with Vertucci class 4 (1-2 configuration) in palatal root

I am sharing an interesting 26 endo case with 2 canals within the palatal root. The canal originally begins as one orifice at the usual position of the P orifice and splits into 2 separate canals about mid-root.

The case was originally referred to me as the previous dentist had trouble finding the DB canal. On examination of the pre-operative CBCT, I could see an iatrogenic gouge around the DB position at the pulp floor chamber. This gouge was roughly where I would conventionally expect to see a DB orifice. The CBCT showed 2 separate canals emerging within the palatal root. In this case, as the P and DB roots were likely fused, the DB canal was hidden and challenging to locate.

Preoperative radiograph

Pre-operative CBCT 26

To gain access to the DB canal, the palatal orifice was widened with gates glidden #1 to about the level of the split. At that point, direct visual access into the DB canal allowed for instrumentation.

Post-operative radiograph