Treating Curved Canals

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IN ENDO-MAIL for October-December, 2010, I wrote about treating long roots. This time I want to talk a little bit about treating curved canals. As an endodontist, I treat curved canals on a daily basis (see Figures 1 through 5).

First of all, having straight-line access is important because it will decrease the stress put on the files during instrumentation; without straight-line access, stress on the files may cause separation and other iatrogenic errors, such as ledging, transportation, and zipping.

Straight-line access can be achieved by using a long-shank diamond bur and surgical round bur to remove the roof of the pulp chamber completely.

Then an endodontic explorer should be used to determine the path of insertion. That is the next important aspect because determining the path of insertion will tell you how the endodontic files and instruments should be angulated when instrumenting and how the guttta-percha points should be shaped when filling the canals. Finally, do not use lentulo spiral or bi-direction spiral beyond the curvature of a severely curved root because the instrument can separate.

January - March 2011

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Figure 5