Three Portals of Exit in Lower Premolar
Lower Right Second Premolar (LR5)
Clinical Radiographs
Case Details
Patient
Male, late 40s
Presentation
Lower right second premolar with severe pain and swelling following a deep filling. Referred for advanced treatment.
The Challenge
This tooth had three separate openings (portals of exit) at the root tip. The canal branched near the apex into three distinct pathways, each of which needed to be cleaned and sealed for successful treatment.
Treatment
Electronic apex locator readings suggested multiple exits. Under microscope guidance, the canal was carefully instrumented to maintain all three pathways. Warm vertical compaction filling technique was used to ensure filling material reached all three exits.
Outcome
Post-operative radiograph clearly shows filling material exiting through all three separate portals. Complete symptom resolution.
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