Page 22 - The Beauty and Sorrow in Endodontics-Prologue

Case 9

Lateral canal is often present where there is a bulge on the root

(Fig 9A) (Fig 9A)

A lateral canal is suspected where a Post-obturation radiograph shows the
sudden bulge appears on the root of a path where the referring dentist was
calcified 34. searching coronally as well as the
#

lateral canal at the bulge and

accessory canals at the apex.

#
The left mandibular first premolar ( 34) has a unique structure at the apical part
of the root resembling a bulbous root tip (Fig 9A). This may be a result from a

disturbance during root development, and one should expect a more complicated root
canal system in these cases. The referring dentist suspected a calcified canal as he was
not able to negotiate the file into the canal. It can be seen on the post-treatment

radiograph at the coronal third that the referring dentist was slightly off-path when
searching for the canal (Fig 9B). This often occurs when the original shape of the crown
of the tooth in question has been altered, or if the tooth is rotated, tilted, or misaligned.
Especially with lower molars and premolars, even under normal circumstances, the
crowns of these teeth are tilted slightly toward the lingual, making it harder to locate

canals.
After locating the path of the original canal, proper cleaning, shaping, and
obturation was then completed. Overfilled sealer and white-in-white dots present of the

post-operative radiograph further confirms the presence of a lateral canal at the bulge of
the root as well as multiple accessory canals near the apex of the tooth.
20