The Furcation Accessory Canal

Terry Pannkuk, DDS, MScD Complications: Advanced Management, Calcification, Endo-Perio Combined Lesions, Recall Observations

"The Devil is in the Details" - Ludwig Mies Van Der Roh

Meticulous debridement of the entire root canal system is important for a predictably successful endodontic treatment result.

Patient: 70 year-old female (time of treatment, 84 year-old at recall), history of breast cancer and managed hypertension, pacemaker (2018)

Chief Complaint: 10/2/2006: cold and biting sensitivity localized to the mandibular right first molar (#30)

Dental History: The patient presented with the said symptoms on 10/2/2006 after having a crown procedure started 3 months earlier, a temporary crown had been placed (#30).

Significant Findings (#30): Clinical examination revealed a 4mm periodontal pocket at the mesiolingual area, slight percussion sensitivity, and a sharp-transient response to cold thermal testing. The periapical and horizontal/bitewing radiographs demonstrated severe pulp chamber calcification, and an incipient furcation radiolucency.

Pulp and Periradicular Diagnosis (#30): Stressed pulp with calcific degeneration, acute periapical periodontitis.

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