Diagnosis
The patient presented with pain in the upper left quadrant. Clinical testing localized the discomfort to tooth #15 which lead to a diagnosis of irreversible pulpitis with symptomatic apical periodontitis. The CBCT revealed an atypical root morphology with two distinct palatal roots and a length of 25mm.
Challenge
The presence of two distinct palatal canals instead of the typical one adds complexity to the case. Understanding the root canal anatomy through radiographs and CBCT, is essential for success. Additionally the long root length and access through a crown made visualization, canal navigation, and irrigation more difficult.
Treatment
Access was extended to allow the location of the second palatal canal. Flexible EdgeX7 rotary files were used for cleaning and shaping, followed with warm vertical condensation. Seven years later, the patient returned for treatment on tooth #14, while tooth #15 displayed excellent healing, and the patient remained asymptomatic. The post-operative radiograph now reveals a "sea of canals.”