Complex Anatomy

Ledge Bypass in Upper Molar

Upper First Molar (UR6)

Clinical Radiographs

Pre-operative radiograph showing ledge in upper molar canal
Pre-operative
Post-operative radiograph showing complete obturation after ledge bypass
Post-operative
Alternative post-operative radiograph after ledge bypass
Post-operative (Alt)

Case Details

Patient

Female, mid-30s

Presentation

Referred with a partially treated upper molar. A previous dentist had begun root canal treatment but was unable to complete it due to a procedural difficulty inside the tooth.

The Challenge

A ledge (a small shelf of dentine created during a previous treatment attempt) was blocking the natural pathway of the canal. Instruments could not pass beyond this point without advanced techniques.

Treatment

Using the dental operating microscope at high magnification, the ledge was carefully bypassed using pre-curved small-diameter files. Once the true canal path was re-established, all canals were cleaned and sealed.

Outcome

Successful obturation of all canals to full working length. The patient reported complete resolution of discomfort.

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