Extraordinary medical findings have always stirred the spirits of both professional and lay public, and cases of teeth with extremely long roots (radiculomegaly, root gigantism) are no exception. One such case report was recently published in the SDJ, and the story was reported in several daily newspapers (Frankfurter Neue Zeitung, Deutsche Welle, Jutarnji list).
Lukas et al. (2019) described the management of a 63-year- old Croatian male patient with an abscess of the canine fossa caused by an avital right maxillary cuspid. No other medical is- sues were reported. Extraoral swelling reaching the infraorbital area, previous history of endodontic treatment, and the radio- graphically established extraordinary length of the tooth con- tributed to the final decision to extract the tooth. The extracted canine measured 37.2 mm in length. In odontometric studies, the maximum measured lengths of the maxillary canine were 32.0 mm (Black 1902) and 33.3 mm (Bjorndal et al. 1974). The published photograph of the tooth indicates that the crown length was about 11 mm, and the root length was about 26 mm. A comparison with the average dimensions of the maxillary canine reported by De Jonge (1958) shows that only the root was exceptionally long (26 mm vs an average value of 16.1 mm), whereas the crown had an average length (11 mm vs an average value of 10.9 mm). The ratio of root length to crown length (2.4) far exceeded the average value for the maxillary canine (1.5). The external morphology of the extracted canine was normal. On the panoramic radiograph, it can be seen that the contralateral maxillary canine and both mandibular canines also have elongated roots. Another feature not mentioned by the authors is the taurodontic appearance of the left maxillary first molar.
According to Lukas et al. (2019), this was the longest tooth ever extracted from a human being. Unfortunately, this is far from the truth. Their claim is based on information from the Guinness Book of Records rather than a review of the scientific literature. Several published case reports describing much lon- ger extracted cuspids exist. Foremost is a case reported by Hay- ward (1980); the lengths of incisors and canines which were surgically removed from an African American girl were between 35 mm and 52 mm. Marashi & Gorlin (1990) presented maxillary canines extracted from a young female patient; the longest of them measured 47.0 mm. De Jonge (1958) reported a 45.7 mm long extracted maxillary cuspid. Wilkie & Chambers (1990) pre- sented a left maxillary cuspid with a length of 41.0 mm, which was extracted from an Australian female patient born in Hol- land. Weine (1986) presented a right maxillary cuspid with a length of 39.5 mm, which was extracted from a Canadian male patient. Schulze (1987) reported a 39 mm long extracted maxil- lary cuspid. Compared to these cases, the length of the tooth described by Lukas et al. (2019) – despite the laurels of the new Guinness record – is relatively modest. ...
