August 2008

Buccal caries and root canal therapy

R.Sathyanarayanan

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Buccal caries present on the molars will complicate the root canal therapy because of difficulty in locating the mesio buccal canal. This case shows series of photos explaining such problem. Preoperative image on occlusal surface shows no evidence of any pulpal pathology while buccal aspect reveals a large carious lesion with pulpal involvement.

 

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The access cavity is carried out normally with agenda to locate the distal orifice as it is the largest root canal and easiest to locate.

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Following location of the distal orifice, the access cavity was extended towards the mesio buccal to locate the mesio buccal canal. Because of profuse bleeding indicating that the pulp is hyperemic, it was not possible to locate the mesiobuccal orifice.

 

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 This is the ideal situation where conservation of tooth structure should be sacrificed as the primary aim is to locate, clean and shape the canals. The buccal cusp along with soft caries was removed. This simple removal of tooth structure paved way for easier location of the mesial canals. The case was completed successfully.