Q. Would you discuss the process for locating previously missed canals associated with endodontic failures?
A. Clinicians need to completely understand and fully appreciate the anatomy of human teeth and use this knowledge to locate calcified, aberrant, or previously missed canals. One of the common causes of failure in endodontics is missed canals which hold tissue, and at times bacteria and their related irritants. These breakdown products inevitably contribute to clinical symptoms and lesions of endodontic origin. There are multiple concepts, armamentarium and instruments that are useful to locate canals, including anatomical familiarity, radiographic analysis, magnification and lighting, complete access, ultrasonics, microscopes, dyes, sodium hypochlorite (NaOCl), color and texture, removing restorations, probing the sulcus and, when appropriate, a timely referral. I also refer you to the Ruddle on Retreatment
DVD "Disassembly & Missed Canals" and/or the Ruddle on Shape•Clean•Pack
DVD as each have sections that clearly show a number of methods to finding canals.