endomontreal

Case study number: 297716

Primer molar superior(maxilar), en el que se utilizaron limas especiales para poder dar la curvatura ideal al conducto ya que presentaba una dilaceracion(curva)marcada hacia distal. Despues de realizar el tratamiento, se alcanza a observar claramente la curvatura del canal  radicular mesial.

Extreme endodontic procedure. Case number: 334

A Vertucci type V pulp space configuration can be described as follow: One canal leaves the pulp chamber and divides short of the apex into two separate distinct canals with distinct foramina (1-2). According to Vertucci’s study in 1984 on a 100 mandibular molars sample, the type V configuration in distal root, occured only in 8% of the teeth examined. In the apical third of distal root, each part of the split as been individually cleaned, shaped and filled with gutta Percha and Pulp Canal Sealer. 

This is a type V Vertucci's root canal configuration on a SECOND maxillary molar palatal root canal. An extremely complexe root canal configuration to clean shape and fill. The root canal is already very difficult to perform due to tooth position in the arch. Patient was having an A.A.A. at this time, making this experience a challenging one for both of us… Treatment took a total of three appointments because of the apical delta and because of calcified second mesiovestibular canal to treat.

Esta es una configuracion de canal radicular tipo V Vertucci's;de un conducto radicular palatino en un segundo molar maxilar(superior). Una configuracion radicular extremadamente compleja para limpiarla y llenarla. El tratamiento radicular(endodoncia) es  muy dificil llevar a cabo debido a la posicion del diente en el arco. El paciente estaba teniendo un A.A.A. al mismo tiempo, haciendo de esta experiencia un reto para ambos… El tratamiento tomo un total de tres citas por el delta apical encontrado en el canal palatino y por la calcificacion del segundo canal mesiovestibular tratado.

Second mesiobuccal canal entry (MB-2) in this upper molar was blocked by a 2mm thickness of sclerotic dentine. This canal alone took more than one hour to locate under a dental operating microscope and treat. Missing this one canal with its own portal of exit would have led to an apical abcess wich would have implied an apical surgery or an extraction and an implant supported crown somewhere down the road.

Third X ray image shows a one year post operative recall with perfect healing.

Potential risk factors that might have complicated treatment:

Canals not visible on mesiovestibular root on pre-operative X ray

S- shaped curve on palatal root canal

Calcified canal system, severe curves and an aberrant location of MB2 made this R.C.T. a rather complex one. 

Este es un tratamiento radicular complicado debido a la dificultad para acceder al conducto, ademas de la curvatura que presenta la raiz en su tercio radicular que realizando una mala instrumentacion podriamos ocasionar una perforacion lo que pondria en riesgo el exito del tratamiento (endodoncia). En la ultima radiografia tomada un ano despues podemos observar que el tratamiento fue un exito.