Severely Curved Molar Instrumentation and Obturation

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Root canal treatment can be quite challenging when it comes to curved canals. The following are the most significant challenges related to root canal treatment in severely curved canals:
  • Negotiating the canal
  • Avoiding transportation
  • Avoiding instrument breakage
  • Three Dimensional Obturation

Figure 1 shows a preoperative radiograph of tooth #3 with severely curved MB root canal system. When negotiating a curved canal, gaining straight access is the key to success. To that end, I used Peeso Reamers sizes 1 and 2. The goal is to avoid transportation using small pre-curved reamers and irrigation. I used rotary instrumentation once a glide path was established. Using brand new rotary files and copious irrigation will decrease chance of instrument breakage.

Figure 2 shows master cone measurement film and Figure 3 shows final radiograph after obturation of root canal system. EZ-fill sealer and warm vertical condensation technique were used to obturate the canals.

The following is the sequence of instrumentation used in this case:

  • Local anesthesia, rubber dam placement and access
  • Locating canals
  • Hand instruments all canals to estimated working length up to size 15 Reamers
  • Gaining straight access using Peeso Reamers sizes 1 and 2
  • Hand instrument MB canals to size 20 Reamer
  • Completion of instrumentation using rotary instruments up to apical size 35
Figure 1
Figure 2
Figure 3