Concluded Case

Sur i could not find all root canals in 1st sitting rct.can it cause severe pain swelling what to do

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Yes, if pulp is not expirated in 1st sitting pain and swelling may increased, or if there is alveolar abcess with active discharge, closed dressing after 1st sitting may increase pain and swelling and due to acute exerbation of chronic lesion associated with tooth cause the same problem. In 1st sitting pulp extirpation from all canal is essential follwed by abundant irrigation. For weeping canal kept it open until oozing of pus occured follwed by warm saline irrigation and closed dressing and appropiate antibiotic coverage and NSAIDS.
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Yes, if pulp is not expirated in 1st sitting pain and swelling may increased, or if there is alveolar abcess with active discharge, closed dressing after 1st sitting may increase pain and swelling and due to acute exerbation of chronic lesion associated with tooth cause the same problem. In 1st sitting pulp extirpation from all canal is essential follwed by abundant irrigation. For weeping canal kept it open until oozing of pus occured follwed by warm saline irrigation and closed dressing and appropiate antibiotic coverage and NSAIDS.
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Try to take an IOPA before you do access opening so that you will get an idea of canal position and number and position of roots , if you could not fund all canals than place files in other canals and take an iopa to get an idea of possible missing canal location , wide the access opening till canal orifice and try spoon excavator to clear the pulp chamber , keep irrigating with Sodium hypochlorite , and use No.10 or No.8 file to find canal , if still not able to find than give open dressing
Yes, in very first sitting you must be try to negotiate all the possible canal...ie is first step of rct straight line access opening and pulp debridement
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1
You can use scaler for chamber cleaning it will remove all the debris and canals will be easily located
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