Complex variations in the root canal system can significantly impact treatment outcomes and lead to failure. This report describes a case of a 32-year male with an unusual anatomical variation (supernumerary root) in the left maxillary central incisor, with a chronic apical abscess diagnosed by radiographic and cone beam computed tomographic images. The lesion was treated by root canal treatment of tooth #21, followed by apicoectomy of the main root and excision of a supernumerary root. The root canal was sealed with mineral trioxide aggregate (MTA) and the defect was filled with bone graft material. A follow-up of three months, six months, and one year showed normal healing. Identifying root anatomical variations using advanced diagnostic methods significantly enhances the treatment success rate. Dentists must recognise the diverse root canal morphologies to improve clinical diagnosis and treatment prognosis.
Keywords: Supernumerary root, Cone-beam computed tomography (CBCT), Root anatomical variation, Apicoectomy.
