The Periapex » Morphology

Six Canals in a Lower Molar?

Periapex — Wed, 11 May 2011 16:10:08 +0000

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:

I Must Have a Boring Job…

Periapex — Mon, 09 Jun 2008 14:44:03 +0000

…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.

Do Not Try This Root Canal at Home.

Periapex — Tue, 18 Mar 2008 22:27:35 +0000

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…

A Sexy Root Canal?

Periapex — Wed, 30 Jan 2008 23:10:58 +0000

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.

Case of the Week.

Ameloblast — Thu, 20 Dec 2007 20:29:00 +0000

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.

Unusual Tooth of the Week.

Ameloblast — Mon, 10 Sep 2007 20:15:00 +0000

This 5 was a case I did about a year ago that ended up needing to be retreated because of symptoms. I found two canals back then, but was always suspicious of an extra canal because of the tightness of the buccal canal that I’d found and the strangeness of the root anatomy on film.

During the retreatment I was more aggressive at searching for another buccal canal.

Two Canals in a Lower Premolar.

Ameloblast — Fri, 17 Aug 2007 11:49:00 +0000

They were really tight. Hopefully the tooth just has these two and no others that I wasn’t able to find.

Curved Canals of the Week.

Ameloblast — Wed, 08 Aug 2007 18:25:00 +0000

The rotation of this tooth allows us to see curves that would otherwise not appear as obviously on film. The rotation also allows us to get a good look at how the second MB canal merges with the first.

Skewed Canals.

Periapex — Tue, 15 May 2007 17:15:00 +0000

This case was referred because the dentist started the endo and could only find 2 canals that were in an unusual configuration. That’s a duplicate of a working film that they took and sent with the patient.

After I got in and did some clean up, the 3 canals I found were configured as ML, B, DL. It’s a variation of a C-Shaped canal system.

A Surprise Inside.

Ameloblast — Thu, 03 May 2007 17:30:00 +0000

I’m almost finished posting all of my interesting archived cases. Just one more to go after this one:

This one is from about 6 years ago, which explains the multiple backfill voids in the obturation. Anyway, I don’t know how many of my peers would attempt a retreat on this tooth. That post which looks like it would tack down drywall appears menacing to remove. It actually came out extremely easily. That was a pleasant surprise. The other surprise was the fifth canal.

That’s one mutant tooth.