The Endo Fix

Tag: root form appropriate instrumentation

Large Canals

Daily Fix

Hampton Roads Endodontics

Kind of rare to see these wide open canals on a 60 year old. The patient initially presented with buccal probings to the apex on this second molar. I used some pre-bent 10 and 15 files on the distal, mesial lingual, and mesiobuccal canals. I used a 7.04 rotary file on the mid-mesial canal. Instrumenting large canals takes a little more time. Continuous taper shaping of these canals would have likely perforated it coronally.  So for these large canals, this is root-form appropriate instrumentation of the internal aspect of the root. Looks like there were 3 POE’s on the MB root. The lateral canal evident on the postop may have contributed to the furcal blowout.

-Trudeau

“T”!

Daily Fix

This post was originally my second Endofix post 7 about years ago. As I got a more recent recall I thought it reasonable to freshen it up some. This is a primary tooth (T), I treated 15 years ago. Looks like it’s still hanging in there, which is actually kind of surprising to me- an unexpected outcome in the positive if you will. Primary teeth have very thin, spindly roots so large shapes are contraindicated. This is one of the teeth that helped “shape” my ideas about root form appropriate instrumentation. Back then we were providing “deep shape” which was often a continuous taper .08. For sure these roots couldn’t tolerate those deep shapes. The notes say we finished with a 25.04 which were very conservative at the time. It helped me understand the concepts of necessary and sufficient. In this case the instrumentation was sufficient to accomplish complete resolution of symptoms and radiographic clearing. Furthermore, that deep shape we liked to see wasn’t necessary. If it wasn’t necessary for this tooth, would it be necessary for other teeth? In some ways this mighty little tooth helped a sea change in the way teeth in general were approached with regard to instrumentation.