Final answer:
For an accessory canal with a necrotic pulp and adjacent lesion, no immediate treatment may be needed if the lesion is asymptomatic and healing. If symptoms persist, treatment options include surgical exposure and curettage, apicoectomy, or re-obturation. Consulting an endodontist is advisable to choose the best treatment approach.
Step-by-step explanation:
In the scenario where an accessory canal is noted in the middle third of a root with a necrotic pulp and a small adjacent radiolucent lesion, it is observed that after obturation, the accessory canal is not filled. The appropriate treatment for this would depend on the presence of clinical symptoms and the extent of the lesion.
Generally, further intervention may not be immediately necessary (No treatment is indicated at this time) if the lesion is asymptomatic and shows signs of healing post-obturation.
However, if treatment is indicated due to symptoms or lack of healing, available options include exposing the root surgically and curetting the lesion, performing an apicoectomy and removing the apical third of the root, or re-obturating using a technique that will ensure the filling material reaches the accessory canal.
Of these, option B, expose the accessory canal opening surgically and retro fill the accessory canal, is not typically the first choice unless the lesion persists or worsens, indicating that the canal system was not adequately sealed.
It is essential to consult with an endodontist to determine the best course of action based on clinical and radiographic findings.