Case 31 Long Canal Systems (25+ mm)

Pre-operative x-ray # 11

Patient was very symptomatic and swollen, it was necessary to place a drain to get her out of pain.  In my practice, drain placement involves incising gum tissue and also exposing the root tip of the tooth to ensure drainage.

Post-operative x-ray #11

Tooth #11 with a working length of 31 mm and numerous lateral apical canals.

In my practice I consider a long canal to be over 25 mm in length. Teeth with long canals are the palatal roots of upper molars and maxillary cuspids. Gutta percha comes usually 30 mm in length.  I see many canal systems in which the apical 3-4 mm is never filled in long canals, which probably means this area was not cleaned successfully either, therefore, having a greater risk of failure. If you are going to treat these types of canals, longer files, i.e. 30 mm files are necessary.