Single visit management of false route in tooth #22. Red arrow indicates false route made by general dentist. Left RVG is initial one made in my office. Green arrow shows where exactly canal lumen is. Canal prepared to size 30.04 (Endostar five) and then apical part enlarged to seize 40.02 (NiTi Two rotary system). Citric acid, hypo, again citric acid, destilated water and CHX as a final irrigant. Note apical delta after CWO.
I love to see such a healing progress in such difficult case. PT came to my office with pain on percussion of tooth 46. Initial RVG shows that tooth was already RCT and have big lesion nearby apex of medial root. It also shows that probably there is zip in apical part of medial canals, and apical surgery will be the option. I decided to try reendo - two visit approach with calcium hydroxide in between. I had huge problems during shaping protocol - no apical patency both in messiahs and distal one. I used a lot of hypo, US, and citric acid. Then I obturate. Third RVG is one year recall -despite technical problems lesion is gone!!!! You don't always need a patency to properly clean root canals!
During broken file removing procedure it is extremely important to block canal orifices. After You locate broken file in canal, close other canals orifices. Once I forgot about it and that gives me additional work. File jump out from one canal directly to another one. I used to do it with cotton pellet but teflon tape is much more comfortable. It is easy to remove after procedure. You can buy it in plumbers shop, divide to small portions and autoclave it. It is brilliant!