How many canals are in that tooth?

2TheApex: Expect multiple canals until proven otherwise.

Except for maxillary anteriors, all teeth should be expected to have more than one canal. Some commonly missed canals are MB2, the lingual canal in mandibular anterior teeth, second (or third!) canals in premolars, and a second distal canal in mandibular molars. Recently I had a very interesting case that was a new one for me: a second palatal canal in a maxillary molar.

Preop:

Pow

Cone fit: Note palatal cone offset to the distal of the root.

pow1

Final: 4 canals, with 2 canals in the palatal root.

pow3

The palatal canals shared a common orifice, and the additional canal was not evident on initial access.  The canals bifurcated apical to the orifice, and the second canal was located with the aid of the dental microscope to the mesial.  A very interesting case, and a good reminder to always expect the unexpected.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s