Retreatment of a Mandibular Second Molar with a Periapical Lesion in a C-Shaped Canal
28/08/2025
Mohamed Milad Ganawo
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Endodontic retreatment of a mandibular second molar with a C-shaped canal configuration presents unique clinical challenges due to its complex and variable anatomy. C-shaped canals, are commonly found in mandibular second molars, retreatment becomes complicated by the difficulty in completely cleaning, disinfecting, and obturating the root canal .
Reasons related to treatment failure include missed canals, inadequate debridement, and poor sealing of the C-shaped anatomy. Successful retreatment requires advanced diagnostic tools, such as CBCT imaging, enhanced visualization with dental microscopes, and specialized techniques for canal negotiation and disinfection.
Fig. 1
Initial situation shows poor permanent restoration, poor and under extended fill, and apical radiolucency.
Fig. 2
After old fill was entirely removed canals cleaned, now cone fit as shown on radiograph.
Fig. 3
Microscopic shot shows root canal map in C shaped way.
Fig. 4
Immediate microscopic shot right after.obturation shows C shaped obturation
Video of the procedure
Fig. 5
Obturation done , and reveals lateral canals
Fig. 6
- pre-operative.
- One year follow up.
Conclusions
The retreatment of a mandibular second molar with a C-shaped canal and associated periapical radiolucency demands Proper diagnosis using CBCT, and use of magnification and ultrasonic instruments.
Effective disinfection with sodium hypochlorite imagination and calcium hydroxide medication improves the chances of periapical healing. Obturation techniques such as thermoplasticized gutta-percha or bioceramic sealers help achieve a three-dimensional seal.
even highly complex C-shaped canal cases can be successfully retreated, preserving the tooth and restoring function, just keep the patient under regular follow up.
Bibliography
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