Birooted primary canines: report of three cases.

B irooted primary canines have been reported only ia few times,1-5 are considered very rare, and have only been diagnosed following radiographic examination. In every report, the birooted teeth have been bilateral and involve the maxillary primary canines, with one report of additional involvement of the mandibular primary canines. There appears to be no sexual predilection, and all but one case occurred in black children and in children with otherwise normal dentitions. Bimstein and Bystrom4 and Bryant and Bowerss reported the patients’ siblings to have normal canines. A summary of the previous cases is presented in the Table. The cause of this phenomenon is unknown but is associated with the development of Hertwig’s epithelial root sheath. This article presents three additional cases of birooted primary canines, including the first reported case of birooted mandibular primary canines in a black child.