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Instrumenting Curved Canals

On 04/25/2010, in Instrumentation, Non-surgical Root Canal, by Vladimir ismens!y, ""#

It is often challenging to clean and shape curved canals. Most, if not all dentists who perform root canaltreatment are familiar with this ugly feeling of breaking an instrument in the canal. I get a jolt down my

spine and “butterflies” in my stomach when it happens.To avoid these types of errors, I come up with a “game plan” and think through every case from thebeginning to the end before I actually do it . It takes only a minute.

!hen I get a curved case, these are some of the things that go through my mind"

#. $low down%%%%%%%%%%&. $traight line access to make those curves gentler.'. (ots of lubricant )*+ rep, -lyde, etc. and irrigation )/a0+l, 12T34. 5se hand instruments more. )I may finish the apical third by hand, pre6curving stainless steel files orusing /i6Ti hand files7. +heck patency more often with 89, : or #;.

9. Instrument in a “crown down” fashion.<. I typically use rotaper files for rotary instrumentation, but in curved cases I will use those forcoronal shaping and may choose rofile instruments )since they are landed and tend to stay centered inthe canal and =ip less to finish the apical third.:. +hoose rotary files with the lesser taper as well, like .;& rather than .;4 or .;9.>. 2o not “push” rotary files, they will break%#;. ?e more conservative with apical enlargement.

+ase #" Tooth 8'&

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+ase &" Tooth 84

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5 Responses to “Instrumenting Curved Canals”

#. $reg says";:@'#@&;#' at :";; pm 

*e suggestion 84 are you finishing the apical third with hand files entirely, at an ;& taper, or arethere handfiles of increased taper as wellA Is the coronal third already tapered open, or do you

finish the apical third first and then the upper & thirdsA?eautiful cases. Bery well done%

Cow do you feel about the m4A

&. mayan! !aurani says";>@&<@&;#' at 4";& pm 

hi doctorcan you elaborate on the type of hand files u would use for such challenges, instrumentationseDuences and any other insights and tips for succesfull management of dilacerated canals.best wishes

'. Vladimir ismens!y, ""# says"##@&9@&;#' at '"#4 pm 

I use hand files, lots of lubricant, may want to consider M4 type handpiece, keep the apical si=esmaller, careful with rotaries. (uck would be really helpful as well.

4. $eorge says";<@;4@&;#4 at 7"#' pm 

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Ci, my Duestion may seem a little inappropriate, but are the rE images posted here made byyouA 3re these your casesA IFm asking because IFve seen these images posted by another doctorwho pretends to be the author. $orry if you find this Duestion offensive.

7. Vladimir ismens!y, ""# says";<@;4@&;#4 at >"'< pm 

I donFt find the Duestion offensive. 1verything I post here is authentic content. I personallytreated every case and took every image. I am flattered that someone wants to use my images.+redit would be appropriate though.

9.