I don’t need too many words for this one. Our patient’s dentist had started the root canal work, found 3 canals, got blocked apically, and then referred.

My post-op film:

Too many canals spread wide to get them all in one shot. In the mirror, lingual is to the right, mesial is to the top of the picture:

In the mirror, from top left to bottom right we have MB, M, ML canals:

In the mirror, you can see DB and D canals:

In the mirror there are D and DL canals:

…If this was my excitement for the day of work that I put in:

It’s an upper second premolar (an uncommon morphologic phenomenon) with 3 canals that I retreated the root canal work on. The first 2 pictures are the before ones, the second 2 are the afters.

Although this case was a tough one for me, I’m glad it was referred here. I’m not sure how it would have turned out in the hands of the patient’s regular dentist.

The complication is the DB root (besides the fact that the patient was very anxious and fidgety and couldn’t open very wide). It’s got a nice s-curve to it with the end of the S being at the last 3-4mm of the root. The curve at the apex of the root is difficult to see on the xray scan, click on the picture for an enlargement. It’s a tough deal for endodontic files to negotiate these types of curves, even if you are using nickel-titanium instruments.

Anyway, I’m heading home for the day now. Don’t worry though, I’m still working on my upcoming post about my misadventures with cockroach blood…

Again, there’s nothing outstanding about this case, but as I looked at the final film, I couldn’t stop looking. The fill density, gentle curvatures in the mesial canals, coalescence of those canals, and the apical canal split in the distal root left me thinking that the endo looks kind of…well…sexy.

I remember our department head once talking about a sexy endo. I also remember thinking how cuckoo that sounded.

Oh well, I guess this is what dentistry does to you eventually.

Nothing earth-shattering here, but this case is another example of how canals can exit roots short of the radiographic apex (RA). For this case, the working lengths were consistently electronically verified. You can even see that the canal appears to stop short of the RA.

My thoughts are that the root actually ends where the canal does and there’s either radiographic artifact or some bony trabeculation that makes it appear longer.