X-rays of root canal therapy showing initial lengths and then final obturation in an upper left first molar of a 40 year-old female. This tooth exhibited calcification of the root canal.

1) & 2) X-ray series of tooth #14 showing a large, old silver filling in a patient who had been experiencing root canal pain. Note the decreased size of the pulp chamber known as teeth calcification. 3) X-ray of endodontic file lengths. Note that the calcified mesial root of #14 initially prevented instrumentation. 4) Final endodontic obturation showing that the mesial root of #14 was located and treated. Chronic inflammation in the dental pulp due to the presence of large, old fillings can increase the difficulty of root canal therapy. Earlier root canal therapy should be considered in these situations.

Photo 1) & 2) Teeth #’s 19 & 18 following removal of large, old silver fillings in a 38 year-old female patient who had been experiencing root canal pain. 3) X-ray of endodontic file lengths. Note that the teeth calcification in the mesial root of #18 initially prevented instrumentation. 4) Final endodontic obturation showing that the mesial root of #18 was located and treated. Chronic inflammation in the dental pulp due to the presence of large, old teeth fillings can increase the difficulty of root canal therapy. Earlier root canal therapy should be considered in these situations. Pictures and x-ray series.

Tooth calcification. 1) & 2) X-ray series of teeth #’s 19 & 18 showing large, old silver fillings in a 38 year-old female patient who had been experiencing root canal pain. Note the teeth calcification – decreased size of the pulp chambers in these teeth. 3) X-ray of endodontic file lengths. Note that the calcification in the mesial root of #18 initially prevented instrumentation. 4) Final endodontic obturation – filling – showing that the mesial root of #18 was located and treated. Large, old dental fillings can cause chronic inflammation in the dental pulp and thereby increase the difficulty of root canal therapy. Earlier root canal therapy – preventive endodontics – should be considered in these situations.

An x-ray of the maxillary right central incisor shows complete obliteration of the canal from tooth calcification secondary to a history of trauma. There was no pain. In the photo note discoloration of the coronal portion of the tooth – this is a common sign of teeth calcification. This is a result of the breakdown of blood in the pulpal chamber and the leaching of hemosiderin into the dentinal tubules.