Citation Information :
Eugine AA, Saji S, Nair KR, Geetha P, Sreepooja C. Retreatment of a Chronically Infected Mandibular Molar with Missed Middle Mesial Canal: A Case Report. Cons Dent Endod J 2021; 6 (1):14-17.
Aim and background: A major cause of the failure of root canal therapy is the inability to locate and treat all the canals of the root canal system. Magnification and ultrasonics are valuable aids in negotiating missed canals. In case of root canal failures with long-standing lesions, a combination of non-surgical retreatment followed by a surgical approach would be more beneficial.
Case description: This case report describes the management of a mandibular molar with a missed middle mesial canal. The canal was negotiated with the help of magnification and ultrasonics. Since it was a long-standing lesion, a surgical intervention was done after the completion of non-surgical retreatment.
Conclusion: Untreated root canals may have a direct impact on the prognosis of root canal treatment resulting in chronic periapical infection. Development in techniques and armamentarium has led to successful identification and instrumentation of missed canals. A surgical approach for a long-standing lesion ensures complete healing.
Baruwa AO, Martins JNR, Meirinhos J, et al. The influence of missed canals on the prevalence of periapical lesions in endodontically treated teeth: a cross-sectional study. J Endod 2020;46(1):34–39.e1. DOI: 10.1016/j.joen.2019.10.007.
Basrani B, Tjäderhane L, Santos JM. Efficacy of chlorhexidine and calcium hydroxide containing medicaments against Enterococcus faecalis in vitro. Oral Surg 2003;96(5):618 De Pablo OV, Estevez R, Peix Sanchez M, et al. Root anatomy and canal configuration of the permanent mandibular first molar: a systematic review. J Endod 2010;36:1919–1931. DOI: 10.1016/s1079-2104(03)00166-5.
Nosrat A, Deschenes RJ, Tordik PA, et al. Middle mesial canals in mandibular molars: incidence and related factors. J Endod 2015;41(1):28–32. DOI: 10.1016/j.joen.2014.08.004.
Tahmasbi M, Jalali P, Nair MK, et al. Prevalence of middle mesial canals and isthmi in the mesial root of mandibular molars: an in vivo cone-beam computed tomographic study. J Endod 2017;43(7):1080–1083. DOI: 10.1016/j.joen.2017.02.008.
Iqbal A. The factors responsible for endodontic treatment failure in the permanent dentitions of the patients reported to the college of dentistry, the University of Alijouf, Kingdom of Saudi Arabia. J Clin Diagn Res 2016;10(5):146–148. DOI: 10.7860/JCDR/2016/14272. 7884.
Mendes EB, Soares AJ, Martins JNR, et al. Influence of access cavity design and use of operating microscope and ultrasonic troughing to detect middle mesial canals in extracted mandibular first molars. Int Endod J 2020;53(10):1430–1437. DOI: 10.1111/iej.13352.
Stuart CH, Schwartz SA, Beeson TJ, et al. Enterococcus faecalis: its role in root canal treatment failure and current concepts in retreatment. J Endod 2006;32(2):93–98. DOI: 10.1016/j.joen.2005.10.049.
Calişkan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J 2004;37(6):408–416. DOI: 10.1111/j.1365-2591.2004.00809.x.