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 canal
treatment 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 the
beginning 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, 12T3.
4. 5se hand instruments more. )I may finish the apical third by hand, pre6curving stainless steel files or
using /i6Ti hand files.
7. +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 for
coronal shaping and may choose ,rofile instruments )since they are landed and tend to stay centered in
the 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 are
there 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 doctor
can you elaborate on the type of hand files u would use for such challenges, instrumentation
seDuences 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=e
smaller, careful with rotaries. (uck would be really helpful as well.
4. $eorge says"
;<@;4@&;#4 at 7"#' pm
Ci, my Duestion may seem a little inappropriate, but are the rE images posted here made by
youA 3re these your casesA IFm asking because IFve seen these images posted by another doctor
who 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 personally
treated every case and took every image. I am flattered that someone wants to use my images.
+redit would be appropriate though.
9.