Extirpation. Don’t lose sight!
We are taught at university that teeth can have 1,2,3,4 or EVEN 5 root canals (or rarely more). Of course, this is really important to know to be able to perform successful endodontics.
Yet we often leave dental school with our extirpation priorities mixed up. When we see a patient who has symptomatic apical periodontitis and is in pain, we need to relieve the inflammatory exudate which is in the periapical tissues. This is a priority.
So on the first visit, find the canals that you can locate quickly and get on with making them patent, so that the inflammation can drain from the apical tissues and relieve the pressure.
Find the canals that you can locate quickly and get on with making them patent
There is always time to find those difficult to locate canals on the next visit when the patient is out of pain and happy with you and your treatment. I quite often leave preparation of the MB2 in upper molars to the next appointment.
Tip from Dr Omar Ikram, specialist Endodontist practicing in Crows Nest NSW, www.specialistendo.com.au.
He also runs an excellent facebook page giving endodontic specific tips, very helpful!