Why does it seem like majority of general dentist/dental students stay away from learning molar root canal?

[LidocaineMane32]

This question is coming from a DH that is pursuing dental school (hopefully starting dental school in 2021) so please excuse my ignorance when it comes to actually performing a molar root canal. I work with a GP who rarely refers root canals out and does molar rcts in ~30 mins. It’s taken him 25 years to ”perfect” this skill but I’ve also seen the importance of having this skill. It helps with 1) patient management 2) production for the office/himself.

my question is: why does it seem like many GP’s and dental students avoid learning how to do molar root canals? Are they just difficult to do? Too much of a liability? Why not do CE’s to learn if you didn’t do a residency?

I recently had a dental school interview and when I asked if the dental students get any exposure to doing molar rct’s 2 of the students said “you don’t want any part of those, just refer those to endo”. That really surprised me coming from a D3 & D4 because I feel like its still early on in their dental career and they’ve already written learning how to do molar rct’s off. Again im just a DH and have never even drilled on a typodont, I just love the field of dentistry and want to soak in as much knowledge as possible. Thank you

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[schmoob]

“you don’t want any part of those, just refer those to endo”. That really surprised me coming from a D3 & D4 because I feel like its still early on in their dental career and they’ve already written learning how to do molar rct’s off.

This is coming from folks who likely have never done any.
I personally enjoy molar endo, but it can get complicated. The variations in canal morphology can become complicated due to accessory canals, negotiating anastamoses, bifurcations, etc. This can make 3D cleaning/shaping/obturation difficult. In the time that it takes to do one tooth you can do a couple of fillings and make the same amount without the headache.

 

[dentistrydmd]

I think a lot of it is that they know that the specialist can do a better job than them, less re-treats in the future, and if you have upper 6's and 7's the MB2 is difficult to do. Also endodontists have better equipment that allows them to work with ease in tough to navigate environments.

 

[HatInTheCat]

Endo is technique sensitive. Things like medical history, accessibility, isolation, onset of pain/symptoms, ability to instrument and debride canals, get patient numb, and canal morphology can all affect the success of the procedure and the prognosis of it as well.

For me, I want to learn, but you have to select cases that won’t be way too involved. It’s the time it takes to do it that’s a concern for me. Hope this helps!

 

[PerioDont]

I will add in some people just don't like to do them. It can be a harder procedure, and endodontists are simply much better at them. That's the beauty of GP, you can just refer the stuff you like less

 

[TanMan]

Fear of the unknown, constant conditioning of how "hard" it is, and lack of proper tools. It's not that hard. I find it's more predictable than maxillary laterals.

 

[LidocaineMane32]

Fear of the unknown, constant conditioning of how "hard" it is, and lack of proper tools. It's not that hard. I find it's more predictable than maxillary laterals.

Did you learn through residency or CE’s?

 

[LidocaineMane32]

This is coming from folks who likely have never done any.
I personally enjoy molar endo, but it can get complicated. The variations in canal morphology can become complicated due to accessory canals, negotiating anastamoses, bifurcations, etc. This can make 3D cleaning/shaping/obturation difficult. In the time that it takes to do one tooth you can do a couple of fillings and make the same amount without the headache.

Yeah I’ve heard that it takes a long time to complete one when you first start but id like to learn (eventually), I feel like it’d make me a better comprehensive GP. I’ve learned from the dentist I work with that I’d be smart to schedule these procedures at the end of the day so it doesn’t cut into other productions throughout the morning/afternoon. what do you think of this?

also, do you feel like a residency is a must to get good at complex endo cases or can it be learned over time with quality CE courses?

 

[TanMan]

Did you learn through residency or CE’s?

Neither. Essentially on the job training.

 

[FutureDent020]

Yeah I’ve heard that it takes a long time to complete one when you first start but id like to learn (eventually), I feel like it’d make me a better comprehensive GP. I’ve learned from the dentist I work with that I’d be smart to schedule these procedures at the end of the day so it doesn’t cut into other productions throughout the morning/afternoon. what do you think of this?

also, do you feel like a residency is a must to get good at complex endo cases or can it be learned over time with quality CE courses?

Don’t do molar endo until you can do it just as well as an endodontist. Not necessarily as fast, but as well. That’s the real answer. You’re expected to be the best at crowns and fillings. You should hold yourself to the same standard with Endo.

Very few of my friends do any Endo. Doing molars correctly take to long for them and then as tanman said, laterals or incisors can be unpredictable. They spend all their CE and time learning implants and doing fixed restorative tx. That’s where the big money is for a GP. Especially with digital impressions and in office milling/ labs.

If you enjoy Endo, sure do as much as you want. But as I said before, you are expected to deliver the same quality as an endodontist.

 

[2TH MVR]

Don’t do molar endo until you can do it just as well as an endodontist. Not necessarily as fast, but as well. That’s the real answer. You’re expected to be the best at crowns and fillings. You should hold yourself to the same standard with Endo.

Very few of my friends do any Endo. Doing molars correctly take to long for them and then as tanman said, laterals or incisors can be unpredictable. They spend all their CE and time learning implants and doing fixed restorative tx. That’s where the big money is for a GP. Especially with digital impressions and in office milling/ labs.

If you enjoy Endo, sure do as much as you want. But as I said before, you are expected to deliver the same quality as an endodontist.

Spoken like a true future specialist. Predictably this will fall on deaf ears. There will always be those GPs that will push the bounderies. Of course there are GPs @drcobad, etc. who are very talented at doing those procedures (insert: molar endo, ortho, perio, implants, surgery, sedation, pedo, etc. etc.) and then there is everybody else. The "everybody else" results will be acceptable based on that dentist's definition of acceptable. An average dentist's definition of acceptable vs. a specialists definition of acceptable are different. I always use this phrase: "You only know what YOU know. You don't know what YOU don't know". If your knowledge and experience is limited .... then your treatment will be limited to your level of expertise.

And yes. Of course there are some bad specialists.

Who are you going to trust? The GP who can competently do molar endos once in awhile or an endodontist who does these all day, every day with all the latest tools, residency knowledge, experience and specialty CE. I know who I would trust to treat my family.

Turf wars have been around forever ..... and it's only getting worse.

 

[TanMan]

Don’t do molar endo until you can do it just as well as an endodontist. Not necessarily as fast, but as well. That’s the real answer. You’re expected to be the best at crowns and fillings. You should hold yourself to the same standard with Endo.

Very few of my friends do any Endo. Doing molars correctly take to long for them and then as tanman said, laterals or incisors can be unpredictable. They spend all their CE and time learning implants and doing fixed restorative tx. That’s where the big money is for a GP. Especially with digital impressions and in office milling/ labs.

If you enjoy Endo, sure do as much as you want. But as I said before, you are expected to deliver the same quality as an endodontist.

I think what's lost in the message of endodontics is the biological objectives of root canal therapy and its relation to the end goal(s) of restorative function, pain relief, and biologically sound treatment. When starting out, it's important to learn how to be efficient (not necessarily fast), but try and make every case a learning experience. Restorative and endodontics go hand in hand and it's important to understand why when one fails, the other will too. Efficient != Fast, but slow doesn't always equate to better either.

I enjoy mandibular incisors and the challenge of two separate canal systems that I often find. Maxillary laterals, ugh, we usually have to resort to an apico when the PARL fails to resolve.

 

[Molar Whisperer]

IMO the reason most dentists don't do RCTs especially molars is inefficiency. For the time it takes one to complete a RCT especially a molar, a dentist could do crowns, fillings, implant restorations, etc. I've been acquainted with a few high producing dentists who refer all endo.

Spoken like a true future specialist. Predictably this will fall on deaf ears. There will always be those GPs that will push the bounderies. Of course there are GPs @drcobad, etc. who are very talented at doing those procedures (insert: molar endo, ortho, perio, implants, surgery, sedation, pedo, etc. etc.) and then there is everybody else. The "everybody else" results will be acceptable based on that dentist's definition of acceptable. An average dentist's definition of acceptable vs. a specialists definition of acceptable are different. I always use this phrase: "You only know what YOU know. You don't know what YOU don't know". If your knowledge and experience is limited .... then your treatment will be limited to your level of expertise.

And yes. Of course there are some bad specialists.

Who are you going to trust? The GP who can competently do molar endos once in awhile or an endodontist who does these all day, every day with all the latest tools, residency knowledge, experience and specialty CE. I know who I would trust to treat my family.

Turf wars have been around forever ..... and it's only getting worse.

My definition of acceptable work is if it is on your own teeth or your family's. When I was doing full time referral GP endo for my last DMO, there were a lot of critics of GPs doing endo. I was determined to do my RCTs just as good as endodontists (standard of care). After doing about 9500 cases, I definitely know which cases I can do and those I will refer (an endodontist couldn't find the MB2 with PARL on my pt and needed another appt). IMO, the game changers for doing great endo are 1) microscope, 2) ultrasonics for best apical debridement 3) Pulp shaping burs, 4) reliable apex locators, 5) reciprocating rotary systems, 6) possibly bioceramic sealers like Brasseler Endosequence BC Sealer through further case studies and followups. I like the bioceramic's potential for minimal post-op pain. I like to hype the sealer to my pts that it is the latest and greatest and perhaps it may be placebo?

 

[Molar Whisperer]

Yeah I’ve heard that it takes a long time to complete one when you first start but id like to learn (eventually), I feel like it’d make me a better comprehensive GP. I’ve learned from the dentist I work with that I’d be smart to schedule these procedures at the end of the day so it doesn’t cut into other productions throughout the morning/afternoon. what do you think of this?

also, do you feel like a residency is a must to get good at complex endo cases or can it be learned over time with quality CE courses?

IMO, the dental school endodontist instructors are very protective of their specialty and will make it frustrating for you so they will get more referrals. When I was in the USAF, we had this comprehensive dentist (2 yr military AEGD to be specialist of everything in a remote area) who was so amazing, he inspired me to be like him. My endodontist mentor told me there is no such thing as super GP because we are "a Jack of all trades, master of none."

My sister graduated 11 yrs after me from the same DS. She did way fewer procedures than when I was there. For example, I had to do 4 dentures to her 1, 4 bridges to 1 (more implant technology), 30 crown units (including 4 bridges) to whatever number she had to do which I know is way less. They had fewer pts because there were many Medicaid clinics near the school. My colleague who graduated in 2012 from another school only had to do 5 crowns. I feel DSs are getting less hands on and residencies like AEGD can be very helpful. If you can get a Military Scholarship (HPSP), they can pay or help with tuition while you gain valuable clinic experience.

 

[TanMan]

IMO, the dental school endodontist instructors are very protective of their specialty and will make it frustrating for you so they will get more referrals. When I was in the USAF, we had this comprehensive dentist (2 yr military AEGD to be specialist of everything in a remote area) who was so amazing, he inspired me to be like him. My endodontist mentor told me there is no such thing as super GP because we are "a Jack of all trades, master of none."

My sister graduated 11 yrs after me from the same DS. She did way fewer procedures than when I was there. For example, I had to do 4 dentures to her 1, 4 bridges to 1 (more implant technology), 30 crown units (including 4 bridges) to whatever number she had to do which I know is way less. They had fewer pts because there were many Medicaid clinics near the school. My colleague who graduated in 2012 from another school only had to do 5 crowns. I feel DSs are getting less hands on and residencies like AEGD can be very helpful. If you can get a Military Scholarship (HPSP), they can pay or help with tuition while you gain valuable clinic experience.

We were lucky that our endodontic professors were pretty supportive of us learning. I think the AAE stance overall of case difficulty assessment is a bit of proof that they don't mind GPs doing endodontics as long as we know our limitations. Perhaps that has changed, but I found that garnered a lot more respect for the endodontic specialty than ortho. Ortho in our school was just learning how to refer without learning even the basics. Orthodontists are mostly cool in my book, but the ortho department in my school definitely is not.

If you're able to convince your corporate masters, see if they can get you a lightwalker laser or gentlewave system. It's another definite gamechanger for 3dimensional root canal system disinfection. That, along with 20-30mL+ push of constant heated high concentration hypochlorite w/ constant activation results in ridiculously clean canal systems and reveals anastomoses and apical third branching

 

[2TH MVR]

Ortho in our school was just learning how to refer without learning even the basics. Orthodontists are mostly cool in my book, but the ortho department in my school definitely is not.

C'mon. You already know why.

Orthodontics is unique in that treatment is initiated but completed many months later (often years). Even in residency .... I rarely started a patient and finished them. Pretty much impossible in undergrad to learn much about ortho. I remember back in undergrad my only ortho class was making a Hawley ret and some space maintainers lol. In the clinic .... I knew NOTHING about ortho. The ortho attendings just told me what to do. Point is .... it takes years of experience to know what works and what doesn't. You screw up a case. The damage has been done. Pretty hard to go back and attempt to correct a bad ortho outcome. Not a like a failed molar RCT. It can be redone. Screw up an implant .... it can be redone. Ortho is different.

Of all the specialties .... ortho probably requires more experience since the success of the outcome comes many years later. You can't teach experience in undergrad. Even this new ortho fresh out of residency they hired at my Corp has alot to learn. In ortho .... the fault in your original tx plan shows up many months into tx. Sometimes you can do a midcourse change, but many times .... the damage has already been done. (i,e short roots, didn't take teeth out, should of taken teeth out, etc. etc.)

But hey. Programs are teaching ortho now. Order up some aligners that an overseas lab tech designed with the help of computer algorithms. Slap them in and hope they work.

 

[Molar Whisperer]

Ortho in our school was just learning how to refer without learning even the basics. Orthodontists are mostly cool in my book, but the ortho department in my school definitely is not.

Pretty much impossible in undergrad to learn much about ortho.

My school taught us nothing about Ortho but the National Boards asked us plenty of questions (sorry, not relevant on molar endo)

 

[TanMan]

C'mon. You already know why.

Orthodontics is unique in that treatment is initiated but completed many months later (often years). Even in residency .... I rarely started a patient and finished them. Pretty much impossible in undergrad to learn much about ortho. I remember back in undergrad my only ortho class was making a Hawley ret and some space maintainers lol. In the clinic .... I knew NOTHING about ortho. The ortho attendings just told me what to do. Point is .... it takes years of experience to know what works and what doesn't. You screw up a case. The damage has been done. Pretty hard to go back and attempt to correct a bad ortho outcome. Not a like a failed molar RCT. It can be redone. Screw up an implant .... it can be redone. Ortho is different.

Of all the specialties .... ortho probably requires more experience since the success of the outcome comes many years later. You can't teach experience in undergrad. Even this new ortho fresh out of residency they hired at my Corp has alot to learn. In ortho .... the fault in your original tx plan shows up many months into tx. Sometimes you can do a midcourse change, but many times .... the damage has already been done. (i,e short roots, didn't take teeth out, should of taken teeth out, etc. etc.)

But hey. Programs are teaching ortho now. Order up some aligners that an overseas lab tech designed with the help of computer algorithms. Slap them in and hope they work.

We may not have enough time nor resources to be taught comprehensive orthodontics, but in the very least, they could at least show us how to take care of orthodontic emergencies (wire poking out of a molar tube, fixed retainer broken, etc..) or minor tooth movements such as relapse cases etc.

Edit: Being taught simple applied biomechanics wouldn't hurt the orthodontic profession, but the lack of ortho education besides learning how to refer results in a lot of GPs going in over their head with ortho. The more you educate a GP, doesn't always mean it's going to result less referrals to the orthodontist, but definitely would inform us on case selection. Unfortunately, due to that educational gap, Invisalign and those STO systems are taking the place of what should've been taught in school. FWIW, I hate doing ortho, but I just see a lot of GPs that are attempting ortho without achieving the desired results and the patient has to suffer from it.

 

[oralcare123]

If they teach you how to do ortho or endo you wouldn't want to apply to their residencies. Schools are only required to prepare you to take Board exams. Some ugly truth for you

 

[Bereno]

Molar endo for a GP is analogous to extracting third molars... Sure, there are some GPs that could do it and do well with no complications. The big subtlety is knowing what to do when something goes wrong, and how to fix it - that is why many refer them out.

 

[LidocaineMane32]

Don’t do molar endo until you can do it just as well as an endodontist. Not necessarily as fast, but as well. That’s the real answer. You’re expected to be the best at crowns and fillings. You should hold yourself to the same standard with Endo.

Very few of my friends do any Endo. Doing molars correctly take to long for them and then as tanman said, laterals or incisors can be unpredictable. They spend all their CE and time learning implants and doing fixed restorative tx. That’s where the big money is for a GP. Especially with digital impressions and in office milling/ labs.

If you enjoy Endo, sure do as much as you want. But as I said before, you are expected to deliver the same quality as an endodontist.

Good info. my position right now is waiting to hear back from about 5 dental schools to hopefully attend this upcoming year. My top ones are UK, DCG and UTenn. Apparently UK has good clinical experience with endo and even placing implants. Would you say this “good experience” would be worth choosing one school or the other? Or should I stick to the cheapest/closest to home school bc about all dental school education is the same?

 

[schmoob]

Good info. my position right now is waiting to hear back from about 5 dental schools to hopefully attend this upcoming year. My top ones are UK, DCG and UTenn. Apparently UK has good clinical experience with endo and even placing implants. Would you say this “good experience” would be worth choosing one school or the other? Or should I stick to the cheapest/closest to home school bc about all dental school education is the same?

You posted this message on another thread where you received your answers. Let’s stick to the question at hand.

 

[LidocaineMane32]

You posted this message on another thread where you received your answers. Let’s stick to the question at hand.

Youre right and I received a lot of valuable information from a lot of people including yourself. The reason I’m asking Futuredent020 is because his profile states that he is an Endo resident and I think he’d give valuable feedback. I didn’t have an endo resident comment on that thread. Combining all the great feedback I get from y’all, I can pick a school that’ll prepare me for success. Im trying to be in y’all’s shoes one day

 

[New_Vegas]

I think the biggest issue is that there's not enough molar endo being done at most dental schools for most dental students to get exposure to it (due to specialty programs, etc). That, and it's pretty much a specialist procedure. So to be good enough to do molar endo it's probably a good idea to start doing anteriors, then move to two root premolars... Then go to molars.

Dental school teaches you to become competent at the basics. You aren't going to learn specialist procedures in dental school.

 

[thetoothguy]

No offense but I think you’re focusing on an aspect of dentistry way too prematurely. There’s many reasons why a GP may refer endo (as well as many other procedures), with economical use of their time likely being the biggest reason. I’m not sure if you’re confused or judging general dentists but there’s a lot to learn about the dynamics of being a GP - and you will not learn any of that in school because school and real life are two different solar systems. I respect dentists capable enough of not needing to refer but I also respect those who are humble enough to refer.

 

[aggie-master]

All of my most stressful endo cases I've ever done were molars. The dentists that choose to refer all molar endo are really not making a bad choice, especially if they have other production lined up and they stay busy.

I still do molar endo but the more experience I get, the more molar endo cases I refer. Right now I mostly stick to lower molars with big pulp chambers and canals that are easily visible on a radiograph. I refer all upper second molars for the most part and most upper first molars unless it looks really manageable on the CBCT. I also refer all molar endo cases where they can't open super wide. My goal each year is to not have any cases where I start the case and have to refer after starting. If I feel like I might run into trouble I just refer. I also try not to do many gross pulpal debridements on molars either unless the patient is in lots of pain and the endo can't see them for a long time. I had to do a few during the height of the pandemic scare back in March/April and then had to do one last week because the endodontists I refer to were closed for Christmas and a regular patient was in a ton of pain.

 

[Mauricio45]

I love molar endos! I never did it in dental school because the endo residents pretty much hogged all the molar endos. Luckily, one of the offices I work at, the owner doesn't do any endos, so I got proficient at them.

It's all about practice. Alot of people stay away from maxillary molars and do mandibular molar endos only. I disagree. I think maxillary endos are easier than lower molars. At least with maxillary 1st molars, you can expect MB2s exist 90% of the time. Maxillary 2nd molars, MB2s are less frequent but can exist too. You just have to have a general idea where they exist and use right tools (I.e. munce burs, edge endo 17 taper file, 06 taper handfiles).

I find lower molars more challenging because it can be tricky to find a 2nd distal canal especially if it branches off the main distal canal. Not to mention, harder to freeze lower molars in general than maxillary molars. Also, C-shaped lower molars which can be tough. Also, the middle mesial canals! So far, I haven't come across a middle mesial canal yet but they apparently exist in alot of teeth. It seems alot of lower molars have wide variation in anatomy which is why I find them more of a challenge than maxillary molars. I find maxillary molars more predictable to do.

 

[Mauricio45]

Here's one I just did this week:

 

[Molar Whisperer]

Here's one I just did this week:

View attachment 326304


View attachment 326301

Beautiful endo and nice distal restoration! My problem is starting the RCT and not able to instr MB2. I'm not as heroic as you because I'll have trouble getting the crown margin on the distal and keeping biologic width (crown lengthening). I have to keep my fingers crossed when I take a pre-op crown seat Bite Wing x-ray. You're amazing!

 

[Mauricio45]

Beautiful endo and nice distal restoration! My problem is starting the RCT and not able to instr MB2. I'm not as heroic as you because I'll have trouble getting the crown margin on the distal and keeping biologic width (crown lengthening). I have to keep my fingers crossed when I take a pre-op crown seat Bite Wing x-ray. You're amazing!

Thanks. The Greater Curve Band (Wide) was incredibly helpful for the distal restoration . Otherwise, I wouldn't know what to do.

MB2 is for sure the longest part of the procedure. I find and clean & shape the other 3 "main" canals first and then focus on MB2 last. 6 and 8 taper hand files along with Munce burs, and 17 taper Edge Endo X7 files are very helpful for MB2s.

 

[saydental]

Last week, I tried to access my first maxillary molar and could not find the MB and DB canals. I worked on 3 teeth and was not able to find DB in any of them. Is it always difficult to find the canals on molars or did I possibly get difficult teeth?

 

[thetoothguy]

Last week, I tried to access my first maxillary molar and could not find the MB and DB canals. I worked on 3 teeth and was not able to find DB in any of them. Is it always difficult to find the canals on molars or did I possibly get difficult teeth?

Theres really not enough information here to really give any generalizable statements. Based on your other posts, you seem to still be in dental school. Did your professors note anything about your access? I can only assume you accessed more lingually and thus missed those two buccal canals

 

[Molar Whisperer]

Last week, I tried to access my first maxillary molar and could not find the MB and DB canals. I worked on 3 teeth and was not able to find DB in any of them. Is it always difficult to find the canals on molars or did I possibly get difficult teeth?

Are you working on extracted teeth? Many intact, extracted teeth may have been perio involved and can have a lot of calcifications which makes locating and instrumenting canals very difficult. For maxillary molars, too often I see the access is prepped too Mesial-Distal instead of Buccal to Palatal (I used to finish other dentist's endo at my DMO). The Palatal canal is the easiest to locate. Once you locate it, prep Buccally. Many times you can visualize a "Dentinal Map" on the pulpal floor leading you to the other canals. The DB canal usually situates centrally and as you open it up, it may extend buccally. The MB canal is usually tucked in the far MB corner. Page 275 of this link endodontic11 (endoexperience.com) illustrates what I'm talking about. After you located and opened all the canals, hopefully you can use the pulp shaping bur (Brasseler Endo Z) to smooth all the ledges which will make instrumenting much easier.

 

[saydental]

Theres really not enough information here to really give any generalizable statements. Based on your other posts, you seem to still be in dental school. Did your professors note anything about your access? I can only assume you accessed more lingually and thus missed those two buccal canals

I am in dental school and my professor did tell me the teeth had too much calcification making it harder to locate. So I assume teeth in patient will be better to access. I didn't have a problem in accessing anterior teeth canals which made me question about molars.

 

[saydental]

Are you working on extracted teeth? Many intact, extracted teeth may have been perio involved and can have a lot of calcifications which makes locating and instrumenting canals very difficult. For maxillary molars, too often I see the access is prepped too Mesial-Distal instead of Buccal to Palatal (I used to finish other dentist's endo at my DMO). The Palatal canal is the easiest to locate. Once you locate it, prep Buccally. Many times you can visualize a "Dentinal Map" on the pulpal floor leading you to the other canals. The DB canal usually situates centrally and as you open it up, it may extend buccally. The MB canal is usually tucked in the far MB corner. Page 275 of this link endodontic11 (endoexperience.com) illustrates what I'm talking about. After you located and opened all the canals, hopefully you can use the pulp shaping bur (Brasseler Endo Z) to smooth all the ledges which will make instrumenting much easier.

Yes, we are working on extracted teeth. The only canal I could easily locate was the palatal canal. Thank you for the explanation.

 

[thetoothguy]

I am in dental school and my professor did tell me the teeth had too much calcification making it harder to locate. So I assume teeth in patient will be better to access. I didn't have a problem in accessing anterior teeth canals which made me question about molars.

Don’t get into the habit of making generalizations - it can be both easier and harder, depending on the case. Lower anteriors can be very difficult, despite direct access and line of sight. If you were told there were calcifications then I’m not sure why you’re asking about the difficulty of accessing canals in molars. If your access was sufficient then it stands to reason that it was the calcifications and nothing else that made instrumentation difficult. Was anything else said about the access?

 

[frozenicecreamDMD]

the extracted teeth are horrible to do endo with to be honest. unless it is a non damaged premolars (ext for ortho reasons) with intact canals.

most extracted molars have calcifications. they are good to test the force at which your rotary files break.

 

[saydental]

Don’t get into the habit of making generalizations - it can be both easier and harder, depending on the case. Lower anteriors can be very difficult, despite direct access and line of sight. If you were told there were calcifications then I’m not sure why you’re asking about the difficulty of accessing canals in molars. If your access was sufficient then it stands to reason that it was the calcifications and nothing else that made instrumentation difficult. Was anything else said about the access?

the professor really didn't say anything else. The canals were more spread out in comparison to the premolars.