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Successful endodontic therapy depends on a thorough understanding of root canal anatomy and its variations. Although mandibular incisors are traditionally considered to contain a single canal, numerous studies have reported the presence of two canals with varying configurations. Among these, the Vertucci Type V configuration, where a single canal divides into two separate canals with distinct apical foramina, presents a diagnostic and clinical challenge and may result in treatment failure if the additional canal is not identified. This case report describes the diagnosis and nonsurgical endodontic management of a Vertucci Type V canal configuration in a mandibular right central incisor of a 20-year-old male patient who presented with pain in the lower anterior region. Clinical examination revealed tenderness to percussion, Grade II mobility, and the presence of a sinus opening. Radiographic examination demonstrated a periapical radiolucency with a “fast break” in the canal space suggestive of canal bifurcation. Cone beam computed tomography confirmed a single canal leaving the pulp chamber and dividing into two canals with separate apical foramina. Root canal treatment was performed under dental operating microscope, and both canals were negotiated, prepared, and obturated. A six-month follow-up radiograph showed satisfactory periapical healing. This case highlights the importance of careful radiographic evaluation, CBCT imaging, and magnification in detecting complex root canal morphology and achieving predictable endodontic outcomes.

Cone beam computed tomography; mandibular incisor; root canal anatomy; root canal treatment; Vertucci type V.