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My Casebook 2013-12-12 Healing of peri-radicular area after treating fourth canal A patient presented with pain and swelling on the first upper left molar tooth. Radiographic examination confirmed the presence of peri-radicular radiolucency, possibly caused by infection (Figure 1) Patients such as these are often advised to undergo extraction or apical surgery (apicectomy) without any attempt at re-treatment. This case shows that it is possible to salvage a tooth by re-treatment of the root canal. It is important to always locate all canals. |
. The prosthetic crown was removed and the root canals re-treated. During the process the previously untreated mesiopalatal ("fourth") canal was also located and treated. A new crown was placed. After thirteen months the lesion appeared to have healed (Figure 2). The fourth canal is clearly visible in the radiograph. 
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