Case 11 Buccal access lower anterior

Pre-op x-ray #26 Internal resorption

Pre- op photo

Access photo

Post-op photo

Post-op x-ray #26

Comment:
When accessing lower anterior teeth, many times it is much easier to access from the buccal, especially when the tooth is lingually displaced as it is in this case. Also, buccal access may be more prudent when there is a large buccal restoration and no restoration on the lingual. Natural tooth structure will be saved by accessing the existing restoration.

Internal resporption should be treated immediately when it is first diagnosed. In my experience watching an asymptomatic internal lesion develop is not in the best interest of the patient. The root canal is much easier and therefore the internal resorption is easier to treat when the damage is minimal.

Case 10 Root canal with curved anatomy

Pre-op xray #18
Very curved mesial root.

Post-op xray #18
Completion of root canal.

Comment:
It is important before endodontic treatment is started that one looks carefully at the anatomy of the tooth. Curved roots present many problems including fracture of instruments and incomplete debridment of the canal system, which can lead to failure. At the very least, cases like this, should be referred for consultation.