Accessory canals demonstrated following retreatment of root canals
Retreatments are more challenging as sometimes obstacles need to be overcome before the retreatment of the root canals can begin. In this case the integrity of the crown and aesthetics was paramount. A very small access was made through the crown. Glass fibre posts were removed from all three canals. I had to be very careful not to perforate while removing the fibre posts. The retreatment was performed with the demonstration of a mid-root lateral canal.
glass fibre posts bonded in mesial and distal roots -note distal area
(i)Following my review I noted that the distal canal area was not improving. The core filling and glass fibre post was carefully removed to expose the distal canal only and the canal was obturated to its full length.
(ii)May I assure my colleagues that I am very careful to clean the canal to full length, and if this is not done, the canal is calcified, ledged or blocked. I then also decided to try to improve the mesial canals as my patient was still reporting discomfort at my follow up review appointment.
(iii) With perseverance the length can be negotiated and once further and deeper cleaned, I have found that accessory or lateral canals are demonstrated on obturation insuring a complete three dimensional filling.
RETREATMENT COMPLETED WITH ACCESSORY CANAL
REVIEW SUCCESSFUL (tooth without symptoms)