Navigating complexity: Endodontic management of a mandibular canine with tri canal confluence in a single root

Mandibular canines typically have a single root and a single canal, but variations can occur. This case report presents a 43-year-old man who complained of dull, intermittent, and spontaneous pain in the lower front tooth region for the past 2 weeks. Clinical findings indicated a mandibular canine with a rare anatomical configuration: three canals within a single root that merge to form one, corresponding to the Sert and Bayirli Type XVIII canal configuration. A diagnosis of previously initiated root canal therapy with symptomatic apical periodontitis was made. The patient's diagnosis was confirmed through careful clinical and radiographic examination, including the use of cone-beam computed tomography for detailed morphology. Given the intricate root canal anatomy, a specialized endodontic approach was employed, leading to a successful resolution of the patient's symptoms.