Complex Anatomy

Lateral Canal Exit in Lower Molar

Lower Right First Molar (LR6)

Clinical Radiographs

Pre-operative radiograph showing lower molar with sinus tract — Pre-operative

Post-operative radiograph showing obturation to lateral canal exit — Post-operative

Case Details

Patient

Female, mid-50s

Presentation

Lower right first molar with a persistent sinus tract (a small pimple on the gum that occasionally drained). Previous courses of antibiotics had not resolved the issue.

The Challenge

The main canal in the distal root did not exit at the tip of the root as expected, but instead turned and exited through the side of the root (lateral exit). Standard apex-directed treatment would miss this exit entirely.

Treatment

Using the microscope and electronic apex locator, the true canal pathway was followed to its lateral exit point. The canal was cleaned and sealed along its actual course, ensuring the exit was properly obturated.

Outcome

The sinus tract healed within three weeks. Follow-up showed complete resolution with no recurrence.

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