Case 39 Lateral canals found in the funniest places

Pre-operative x-ray #6

Large apical lesion on the mesial aspect of #6. Buccal tissue is swollen and patient is asymptomatic.

Immediate post-operative x-ray #6

Obturation completed. Note lateral canal on the mesial aspect of the tooth. 

6 mo. post-operative x-ray #6

Patient is asymptomatic and lesion is practically gone. Please note bifurcation at apex also. 

10 mo. post-operative x-ray #6

Lateral lesion has practically healed completely.

Comments:  Lateral canals are often the reason that periapical lesions are present or teeth have continual problems after root canal therapy.  In many cases, they are not seen until after the work is completed. If a lesion remains after a root canal has been done and does not heal, many times unfilled lateral canals are the cause.

Case 38 2 canals often in distal root

Pre-operative x-ray #30

Patient was symptomatic and swollen.

File film #30

Second distal canal was located. 

Immediate post-operative x-ray #30

Retreatment was completed. Mesial canals were also retreated.

10 month check-up x-ray #30

Complete healing after ten months. 

Comments:  Always a choice between a surgical approach and retreatment on any root canal that is failing, if one is assured that a fracture is not the problem. Generally retreatment will confirm that either the canals have been poorly cleaned or other canals that have never been negotiated are present, as in this case of the distal root.