endomontreal

Case number: 482036

Root canal procedure case study number: 29537

Case study in endodontics number: 498946

Root canal procedure case study number: 49821617

Note on the post operative Xray dental film, the dilacerated apical curves in both vestibular roots on second maxillary molar and disto vestibular root of first maxillary molar. The values of those root canal curvature radius based on three mathematical points are all below 4 mm, these are very small radius. Thus, those cuvatures can be defined as severe. For the endodontist, choosing the right endodontic file is of the utmost importance in order to avoid damaging consequences such as: apical transportations, loss of working length, zip and perforations and fracture of instruments.

An interesting point has been raised by Drs Pruett, Clement and Carnes affiliated with the Department of Endodontics/Dental School of University of Texas Health Science Center at San Antonio:" These results indicate that, for nickel-titanium, engine-driven rotary instruments, the radius of curvature, angle of curvature, and instrument size are more important than operating speed for predicting separation".  

Much more can be learned on small curvature radius by reading the following article:  Method for determination of root curvature radius using cone beam computed tomography images                  Carlos Estrela, Mike Reis Bueno, Manoel Damiao Sousa Neto, Jesus Djalma Pécora Braz Dent J (2008) 19(2): 114-118 ISSN 0103-6440

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.