endomontreal

Endodontic procedure case study number: 449927

To treat such a tooth in endodontics we needed to deal with:

• Difficult access
• Long tooth (24 mm)
• Calcified canals (root canal system with dystrophic calcifications) to locate, shape clean and fill 
• Second mesiovestibular (Mb2) to strive for with the help of a dental operative microscope
• Canal curvature with an "S" form (Bayonet shaped root canal) 

Armamentarium:

PRO Taper endodontic files from Dentsply, OPMI PROergo dental operative microscope from Carl Zeiss, Gutta Percha from META, Pulp Canal Sealer from KERR 

Irreversible pulpitis, deep carie, deciduous restoration, broken lingual wall. First molar with 4 root canals. Two mesial root canals no longer visible in middle and apical third with a curvature into "C" form. A file number 08 ISO follows a 90 degrees curvature in one of two distal root canals (per op. X ray dental film).

These canals in the distal root are presenting a dilaceration or sudden angular bend, according to Dr John Ide Ingle: "The major problem in these cases is the exploration, hence the pathfinder curve in the instrument". To my opinion, the main problem is the complete files sequence. These curves require much more endodontic expertise to deal with than the mesial root gradual curve.

Pulpitis irreversible, caries profunda,restauracion obsoleta(caduca, en pesimas condiciones), pared lingual fracturada(quebrada). Primer molar con 4 canales radiculares. Dos canales radiculares mesiales no visibles de lejos en tercio medio y un tercer canal radicular con una curvatura interna en forma de "C". Una lima 08 ISO  seguida con una curvatura de 90 grados en uno de los dos canales radiculares distales.