Dealing with curved canals

My siren started to ring when I saw a pre-op pa radiograph like this one here. My main concerns were not to ledge the canal, maintain patency and avoid separating instrument at the apical curve in the mesial root. This was my strategy. After establishing a glide path with #8 file, I straightened the coronal third of the canal. Making sure that patency was maintained, I precurved all hand files and enlarged it to #20. Subsequently, the canal was shaped with Profile 0.06 taper to to #30.

Retreatment

Each pulp is unique!

This case you referred to me with buccal discharging sinus. Mesial canals were short, distal canal underprepared and peri-apical lesions associated with both roots. Upon re-entry to the pulp chamber space, two distal canals were located, both orifices close to each other.

After dressing with calcium hydroxide for two weeks, buccal sinus was closed and canals were obturated. Gutta percha extruded slightly from the disto-lingual canal, but I'm happy with this case. Will review in three months for radiographic evidence of healing.

Latex-free Root Canal Treatment

My patient who needs a root canal treatment (RCT) on her upper left second molar is very allergic to latex. My nurses and I had nitrile gloves on attending to her and RCT was carried out under a non-latex dental dam.

It is a standard practice to use gutta-percha to fill canals but in this case, we use Resilon, a resin based material.

Treatment was carried out successfully and I'm glad that the patient didn't have an anaphylactic shock in reaction to the allergen.

Unusual C-shaped canal

This right mandibular second molar has a C-shaped canal with a rare canal configuration, a C or oval canal with a single distal canal. The working length peri-apical radiograph looked like there was a perforation at its furcation but that was not the case. Obturation was done with lateral condensation and then warm vertical.