Understanding Treatment Options for Accessory Canal with Necrotic Pulp

What is the appropriate treatment for an accessory canal with a necrotic pulp and adjacent lesion?

A. expose the root surgically and curet the lesion.

B. expose the accessory canal opening surgically and retrofill the accessory canal.

C. perform an apicoectomy and remove the apical third of the root.

D. re-obturate using a technique that will force material into the accessory canal.

E. None of the above. No treatment is indicated at this time.

Answer:

For an accessory canal with a necrotic pulp and adjacent lesion, no immediate treatment may be needed if the lesion is asymptomatic and healing. If symptoms persist, treatment options include surgical exposure and curettage, apicoectomy, or re-obturation. Consulting an endodontist is advisable to choose the best treatment approach.

In the scenario where an accessory canal is noted in the middle third of a root with a necrotic pulp and an adjacent radiolucent lesion, the appropriate treatment depends on clinical symptoms and the extent of the lesion. If the lesion is asymptomatic and shows signs of healing post-obturation, immediate treatment may not be necessary.

If treatment is indicated due to symptoms or lack of healing, options include exposing the root surgically and curetting the lesion, performing an apicoectomy to remove the apical third of the root, or re-obturating with a technique to ensure material reaches the accessory canal. Consulting an endodontist can help determine the best course of action based on clinical and radiographic findings.