CbCT case #2 - locating canals

1 visit lateral incisior Coagulum over implant Trauma- Endo-Surgery Pre bent SS hand files Isolation for post buildup Placing MTA retrofill Horizontal percussion Calcified central incisor Temporary glass ionomer Irreversible pulpitis Ortho and retrograde coronal restoration Cervical hypersensitivity	23 year recall A gone case Weird lesion Huge lesion Pulpitis on 45 Isthmus anatomy 14 year recall Caries exposure Tooth #37 Perio inflammation Severe percussion 2 D healing Crown access	Canal with acute bend Cracked tooth syndrome Tooth discolorisation Mesial systems with POE Endo treatment Newsletter 30th May 2010 Endo implant To CT or not Buccal gingival swelling Polished collar Molar restoration Immediate implant Whiteline puzzle	Final coronal preparation Type 3 Heithersay resorption 19 year recall - Molar case Isthmus Anatomy Acute irrversible pulpitis Horizonatal,vertical percussion Orthoband cases Symmetric resorption Removing Niti instruments Calcified incisor Ca(OH)2 extrusion Resorption defect Apico on MTA

Endo tips Better Endo New additions Endo abstracts Back to home page Endo discussions

CbCT case #2 - locating canals - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com

From: Rob Kaufmann
To: ROOTS
Sent: Monday, June 28, 2010 7:06 AM
Subject: [roots] CbCT case #2 - locating canals

Here's a case that I started on Friday.  Patient arrived with draining buccal sinus and percussion sensitivity
in the right first mandibular molar. Tooth had been restored multiple times and  crowned many years ago.
No responses to pulp tst or cavity test.  Access was a bitch. There were literally NO landmarks left as the
chamber was totally and completely calcified. At that point I was finding the canals "buy color". Lookig for
the border between the white vertical dentin surfaces and the darker apical dentin, I located the ML and D canals
- took me an hour.  Because of the crown, I had no landmarks and I was not sure a to which of the M canals
I had found ( they looked quite close together on access and the  calcification did not help matters.
I started looking lingually but there was a lot of "white" and that generally is not a good sign.
I decided to stop, placed Ca(OH)2 in the canals I did find and took a cbCT at that point.

The cbCT clearly showed that I missed the ML - AND that it joins the MB short of the terminus. Ca(OH)2 meds
slightly out of the foramen.  The next time she returns, finding the canal will be easy.  Without that,
I probably woudl have ended up hogging out the access even more that I have already. - Rob Kaufmann DMD MS(Endo)

Protaper flaring 6 yr old Empress Cvek pulpotomy Middle mesial Endo misdiagnosis MTA retrofill Resin core BW importance Bicuspid tooth Necrotic #8 treatment Finding MB2 / MB3 Deep in a canal Broken file retrieval Molar cases Pushed over apex MB2 and palatal canal Long lower third Veneer cases CT Implant surgury	Weird Anatomy Apical trifurcation Canal and Ultrasonics Cotton stuffed chamber Pulp floor sandblasting Silver point removal Difficult acute curve Marked swelling 5 canaled premolar Sealer overextension Complex anatomy Secondary caries Zygomatic arch Confluent mesials LL 1st molar (#19) Shaping vs Cleaning First bicuspid In Vivo mesial view Inaccesible canals	Premolar 45 Ortho and implant Radioluscency Lateral incisor Obturation Churning irrigant Cold lateral Tipped to lingual Acute pulpitis images Middle distal canal Silver point Crown preparation Epiphany healing Weird anatomy Dual Xenon Looking for MB2 Upper molar resorption Acute apical abcess Finding MB2	Gingival inflammation Irreversible pulpitis AG BU ortho band TF Files using TF files Broken bur Warm technique Restorative prognosis Tooth # 20 and #30 Apical third 3 canal premolar Severe curvature Interesting anatomy Chamber floor Zirconia crown Dycal matrix Cracked tooth Tooth structure loss Multiplanar curves