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Endodontics

How to identify the number of accessory canals while doing RCT?

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The following question was submitted by a practising dentist: How to identify the number of accessory canals while doing RCT?

Dr. Mary Dabuleanu from Dabuleanu Dental provided these initial comments for consideration: 

One never quite knows exactly how many accessory canals are present when you embark in a case. The pre-operative X-Ray may show an area of widened periodontal ligament space along the side of a root, which proves to be a lateral canal on the final X-Ray.

If the root anatomy is tortuous, one can suspect some accessory canals around the sharp bend of the root. Also, bulbous roots tend to have apical ramifications. When irrigants are left to soak in the canal system for an adequate amount of time, you can better fill the accessory canals.

Follow-up: 

What further information would you like on this topic? Email us at jcdaoasis@cda-adc.ca

Readers are invited to comment on this initial response and provide further insights by posting in the comment box which you will find by clicking on “Leave a reply“ below. You are welcome to remain anonymous and your email address will not be posted .

 

6 Comments

  1. Brian Jafine February 8, 2013

    One never knows how many if any accessory canals are present. The question however is “does it really matter?”….the answer is NO.
    When the main body of the canal is cleaned , shaped and well filled, accessory canals are of minimal importance, unless they are extremely large in which case many of these can be identified on a radiograph or with CBCT and will be filled if the canals are properly instrumented irrigated and obturated.
    I have yet to see a case that failed because of an unfilled accessory canal when the main canal or canals were well instrumented and obturated.
    Attention paid to complete and proper instrumentation, irrigation and obturation is the key to successful endodontic treatment

    Reply
    1. VR September 4, 2013

      I believe this also! Otherwise, the number of unsuccessful cases (before we started looking for these) would be higher.

      I also feel that some of these cases show the separate canals at the foramen but become one canal towards the apex. Sometimes I see this with max molar MB canals.

  2. Dman February 12, 2013

    It makes us feel better when we see accessory canals filled on a final film. An Italian study examined these canals. They found they were filled with a mix of crud and sealer.

    Does finding and filling these canals make any difference???? Soak and hope.

    Reply
  3. Robert Kaufmann February 12, 2013

    The term “accessory canal” is misleading and not really useful for the purposes of this endodontic discussion. A more correct term (as first used by Schilder) is “root canal system”. This term better describes the natural anatomy that exists in teeth. “Accessory” canals may sometimes be bigger than the “main canal” so the term is somewhat erroneous. I refer you to the wonderful micro CT work being done by Marco Versiani and his team at http://rootcanalanatomy.blogspot.com for a better appreciation of this concept.

    Reply
    1. Mary Dabuleanu February 22, 2013

      Thank you for your comments! The micro CT work done By Marco Versiani is quite impressive. We are indeed, dealing with intricite “root canal systems”.

    2. Mary Dabuleanu February 22, 2013

      Thank you for your comments. The micro CT work done by Marco Versiani is quite impressive. We are truly dealing with intricate “root canal systems”.

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