Case 25 Lateral canals - many times the key to success

Pre-operative x-ray tooth #5 

Patient presented with symptomatic #5.  X-ray shows lateral lesions on both roots, one to the distal and one to the mesial.

Post-operative x-ray #5

Note: both lateral radiolucensies

Lateral canals in both roots

14 month post-operative x-ray #5

Tooth is asymptomatic and lateral radiolucensies are healed.

Comment: Lateral lesions on teeth with no evidence of fracture usually indicate a lateral canal system. If root canals are done and the lesions fail to heal, I would generally retreat before contemplating other options, i.e. surgery or extraction.