This patient came in for treatment of #11. Single root, single canal, no crown, you would think that this would be an easy root canal. However, notice the calcification of the canal. Sometimes when the crown is gone, it is difficult to determine the long axis of the tooth. You can see the the original access is getting slightly off centered toward the distal & lingual. This wise dentist knew to stop before a perforation occured.
If you look closely (select the image to enlarge), you can see the difference in color between the primary and secondary dentin. You can actually see where the canal used to be, before it calcified in. Right in the center of that secondary dentin is a small white speck. This is where the dentinal chips have accumulated in the canal. That little white spot is the remnant of the canal.
Micro-opener used to open the canal.
Does the top of the canal calcify faster than the rest of it? I guess what I'm asking is if the rest of the canal is as difficult to clean out.
Typically, the tooth calcifies from the coronal portion down towards the apex. Calcification will occur as a natural process of aging, but will also occur as a response to trauma or irritation. That is usually decay, fillings, crowns, gingival recession that occurs coronally.
Once you find the canal, you can usually get all the way down it without any problem.
That was indeed a nice tip on locating the canal..In the rootcanals that i do these days, rarely do i find an ideal dentinal road map that you would so often find earlier.. Most pulp chambers have stones which can be detached.(70%) I was wondering how many of us have experienced the same. The real problem is when you have perforated very near the calcified orifice. Even if you seal it up with MTA, How do you try and locate the actual calcified canal?
What's the latest technology to find a very hard to find calcified root?
Just doing some research as I have one root canal; interesting stuff! Thanks for sharing.
I completely agree with the statement that with no crown spl with anterior teeth, it seems to be a piece of cake doing endo. But my experience remains a little deviated. Dealing with elderly and medically compromised patients, its not the tooth that's hard but its the patient who is sometimes impossible to predict. He/She can swing in any direction making any simple procedure just a hard nut to crack. Thanks for sharing this post.
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