Dr. Shivani Bhatt
“For everyone that asketh …..recieveth
He that seeketh….. findeth
To him that knocketh…. It shall be opened”
The above is one of the many articles that illustrate the importance of detection, cleaning, shaping and filling of middle mesial canals.
I would like to share one of my failed cases because of missed middle mesial canal.
Case treated by me comes with pain again after 2 years
- Severe pain associated with root canal treated 46 in a 28 year old male patient
- 46 with metal crown
- No swelling
- Very tender on percussion
- Root canal treated 46
- Huge radiolucency associated with mesial root
- Failed root canal with 46
- Re root canal with 46
- Removal of crown
- Rubber dam isolation
- Pre endo built up in composite
- Removal of gp points by R-Endo by micromega
- Search for middle mesial canal(mm)
- Where and how to search for middle mesial canals;
- Mm is present in the isthumus between the mesiobuccal and mesiolingual canals more towards the mesiolingual.
- Troughing of the isthmus between mb and ml with
- Scaler tip
- Endo guide bur
- Dg 16 probe
- Irrigation to remove the dentinal shavings
At times the mm meets one of the two canals or both the canals at a point near or above the apex.
Prepare only till that point to avoid weakening of tooth structure.
Preparation of all canals with TF
Apical diameter: mesials-30 distal-35
Irrigation: 5% warm sodium hypochlorite MDA
Calcium hydroxide dressing for 10 days
Obturation: lateral condensation
DISCLAIMER : “Views expressed above are the author’s own.”