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One of the most common causes of failure in endodontics is missing canals.
The middle canal in lower molars is not an exception and has been studied by numerous authors in the literature.
Its prevalence ranges from 0,28% to 53,8% and it’s specially presents in the mesial root.
Using different X-ray angulations or with the help of CBCT we can confirm its existence.
Understanding the anatomy of the teeth is a key factor for the success of our treatment.
In this case we are treating a previously treated lower molar with some hidden anatomy.

A thorough knowledge of the root canal anatomy and its variations is required for achieving success in root canal therapy, along with diagnosis, treatment planning and clinical expertise,  One such variation of the root canal system is the C-shaped canal configuration.  It is termed so because of the C-shaped cross-sectional anatomical configuration of the root […]

The presence of 3 rooted premolars called, little molars, is pretty infrequent. Found in only 1-4% of cases with regional variation. The two morphological types involve either two buccal and one palatal root or two palatal and one buccal root. Managing these cases is demanding due to the rarity and challenges in diagnosis, access, instrumentation, […]

Deep split, also known as Vertucci type V canal anatomy, is one of the most challenging anatomies in root canal treatment. It presents a situation where one canal leaves the pulp chamber and divides short of the apex into two separate apical foramina (1-2). Treatment of deep split could be a significant challenge for the […]

A thorough knowledge of root canal anatomy is essential for predictable and successful outcomes of endodontic therapy. Mandibular premolars are rightly called “endodontist’s enigma” by Slowey, as they are known to exhibit a high degree of variability in their root canal morphology, as compared to other teeth in the oral cavity.  These anatomical variations could […]

The presence or absence of periradicular disease is determined according to clinical and radiographic findings. This article will discuss the non surgical endodontic retreatment of a mandibular first molar with mid-mesial canal.   Endodontic retreatment is a procedure performed on a tooth that have a previous attempt of definitive treatment resulting in a condition that […]

Speaking of ANATOMIC VARIATIONS The clinician should be aware of root canal anatomy and morphology, not to mention the protocol of debridement, disinfection and obturation.  Vertucci5 reported the incidence of one canal at the apex in them at 75%, and two canals at apex at 24%. In the same study, Vertucci5 found maxillary second premolars […]

Straight simple root canals are rare in the human dentition; the majority present with complexities and curvatures in different planes, making the endodontic treatment a complex task that requires adaptation according to each specific case (1). One of these special anatomies is the S-shaped root canal.  The purpose of this paper is to present 2 […]

Apical periodontitis serves an essential protective function aimed at confining bacteria discharged from the root canal space and preventing them from spreading into adjacent bone marrow spaces and other remote sites. The process is unique in the sense that it cannot eradicate the source of infection. The reason is that once a pulp has become […]

Endodontic management of a tooth is an interesting and challenging procedure that is partly blinded, and its success depends on individual clinical expertise and skill, as well as the procedural techniques applied.  Tooth anatomy is the map on which every clinician relies upon prior to initiating root canal treatment. The vast data on tooth anatomy […]

The curved and dilacerated roots in the posterior teeth often present the major challenge to the clinicians during the endodontic treatments. Failure to secure a safe glide path in order to achieve an optimum biomechanical preparation may lead to complications which will jeopardize the final outcome of the treatment due to : Planning should start […]

Endodontic treatment entails thorough chemo-mechanical debridement and disinfection of the pulp spaces, followed by placement of an inert biocompatible material to allow hermetic sealing of the root canal system. Inability to meet either of these objectives can inadvertently lead to endodontic failure. Concomitantly, an awareness of normal and aberrant root canal morphology is a key […]