This was referred by a clinician who started the case thinking it was a regular premolar. Looking at the radiograph that the referral e-mailed me, I was expecting a Two-canalled premolar. The master-cone radiograph showed the lack of centricity of the two canals i had discovered. I went back in and found the third canal.
Whenever I get a case started by someone else, I warn the patient about the fact that I’m not really sure what the previous practitioner has done. Most times, the damage isn’t that bad. Occassionally, we get surprises like this one: A perforation.
This maxillary premolar bufurcated quite deep into two canals. These type of cases are good examples of anatomy that can easily be missed without magnification.
Previous clinician started this case and referred it when the patient continued to have pain. This was a two-rooted mandibular pre-molar with the canals present at a very odd angle and position. It was difficult to clean, shape and pack because the canals were very close to each other. When obturating these canals, I usually […]
This case illustrates step-by step removal of two fiber posts during Re-treatment. Munce burs were used to drill out the fiber-posts. Notice how the fiber posts become invisible when dry and re-appear when wet.
This case illustrates two things. 1) When examining for calcified canals, I like to put some EDTA, scrub the chamber and then examine under the microscope for clues. A cleaner floor is easier for color differentiation. 2) Specially in posterior teeth, canals tend to calcify and appear as “white spots”
This patient had a history of RCT followed by surgery. While Re-treating, in the lateral incisor, i could get a cone-fit with a #45 master cone. The central however, had an open apex and was inflamed. I placed calcium hydroxide for 2 weeks and packed the central with MTA apically.
When Accessing through metal or Metal-ceramic crowns, the apex locator gives wrong readings if the file is in contact with the metal part of the crown. One way to prevent this is to block the metal margins of the access cavity with Opaldam.
The previous practitioner fractured an instrument in the mesio-buccal root and referred this case. Instrument retrieval is usually fast and quite predictable in locations like the middle and coronal thirds.
This patient had sensitivity to cold after an RCT on a lower molar. Sensitivity persisted even after a month. Re-treatment revealed a missed distal canal/root that was still vital and hyperaemic. Here is a short lecture of the same case:
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