You start endo on #2 after a nightmare rubber dam adaptation because of a thick buccinator, interfering condyle and reduced mouth opening. You have accessed 3 canals in 3 roots and you search for the 3rd canal in the MB area. You are ecstatic that that small canal doesn't really exist in the tooth. You place your master cones in the 3 accessed canals after instrumentation and get a radiograph. What you see now throws you aback! There is a 4th canal that you completely missed!
How do you avoid such shockers?
1. Triage - Plan well. Read the pre-op radiograph well. Search for extra roots, calcifications, root anomalies, canal anomalies etc. When in doubt, refer!
2. Visualization - Make sure you work under good lighting and a clean, hemostatic field.
3. Radiographs - Always take a PA after master cones fit and when endo is completed.
4. Avoid 'herodontics' - Do not attempt to be a dental hero! Refer when you think its beyond your capacity! You are a health care provider, first and last! Do what is right by your patient and DO NO HARM!
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