Endodontic Management of S-Shaped Root Canal in a Maxillary Premolar Using Controlled Memory Nickel Titanium Rotary Files – A Case Report

ABSTRAKPendahuluan: Penatalaksanaan kasus penyakit pulpa yang disertai dengan lesi periapikal dapat dilakukan dengan perawatan saluran akar tanpa intervensi bedah. Preparasi biomekanis pada perawatan endodontik non-bedah dapat mengeliminasi bakteri dari saluran akar dan mencegah terjadinya infeksi berulang setelah dilakukannya obturasi. Kompleksitas anatomi menyebabkan keterbatasan preparasi biomekanis saluran akar, sehingga perawatan dapat mengalami kegagalan. Variasi anatomi saluran akar pada gigi molar pertama rahang atas umumnya terdapat pada bagian palatal akar mesiobukal yang disebut sebagai saluran akar mesiobukal kedua dengan insidensi 94%. Saluran akar mesiobukal kedua berukuran lebih sempit dan dangkal dibandingkan saluran akar mesiobukal pertama, sehingga dibutuhkan beberapa metode untuk menentukan lokasi orifis tersebut. Tujuan laporan kasus ini adalah membahas mengenai penatalaksanaan non-bedah gigi pasca perawatan endodontik parsial yang disertai dengan lesi periapikal. Laporan kasus: Pasien perempuan berusia 28 tahun datang dengan keluhan gigi belakang kiri atas sakit berdenyut sejak 1 bulan, gigi tersebut pernah dirawat saluran akarnya beberapa tahun sebelumnya. Pemeriksaan klinis menunjukkan terdapat tambalan permanen pada gigi 26. Pemeriksaan radiografis menunjukkan adanya gambaran radiopak pada email mesio-oklusal hingga mencapai dasar kamar pulpa, pelebaran ligamen periodontal, terputusnya lamina dura, serta lesi periapikal pada akar mesial dan palatal. Preparasi akses dilakukan pada gigi 26, dilanjutkan dengan penentuan lokasi orifis mesiobukal kedua. Empat saluran akar dipreparasi menggunakan instrumen rotary nickel titanium dengan teknik crown down dan dilakukan obturasi teknik kondensasi lateral. Restorasi definitif berupa mahkota penuh porselen. Simpulan: Lesi periapikal sembuh setelah dilakukan preparasi pada saluran akar mesiobukal kedua sehingga pengetahuan mengenai anatomi dan variasi internal saluran akar gigi sangat penting dalam keberhasilan perawatan endodontik non-bedah.Kata kunci: Perawatan endodontik non-bedah; previously initiated therapy; lesi periapical; mesiobukal kedua ABSTRACTIntroduction: The management of pulp disease cases accompanied by periapical lesions can be done by root canal treatment without surgical intervention. Biomechanical preparations for non-surgical endodontic treatment can eliminate bacteria from the root canal and prevent re-infection after obturation. However, the complexity of the anatomy limits the biomechanical preparation of the root canal so that treatment can fail. Anatomical variations of the root canal in the maxillary first molars are generally found in the palatal part of the mesiobuccal root, which is the second mesiobuccal root canal with an incidence of 94%. The second mesiobuccal root canal is narrower and shallower than the first mesiobuccal root canal, so several methods are needed to determine the location of the orifice. The purpose of this case report was to discuss the non-surgical management of teeth after partial endodontic treatment accompanied by periapical lesions. Case report: A 28-year-old female patient complained of throbbing pain in the left upper back tooth for one month. The tooth had had its root canal treated several years before. Clinical examination revealed permanent fillings on tooth 26. Radiographic examination showed the radiopaque appearance of mesio-occlusal enamel to the floor of the pulp chamber, widening of the periodontal ligament, rupture of the lamina dura, and periapical lesions of the mesial and palatal roots. Access preparation was performed on tooth 26, followed by the determination of the location of the second mesiobuccal orifice. Four root canals were prepared using a rotary nickel titanium instrument with a crown down technique and obturation with lateral condensation technique. The definitive restoration is a full porcelain crown. Conclusions: Periapical lesions healed after preparation of the second mesiobuccal root canal. This result proves that knowledge of the anatomy and internal variations of the root canal is fundamental in the success of non-surgical endodontic treatment.Keywords: Non-surgical endodontic treatment; previously initiated therapy; periapical lesions; second mesiobuccal canal

Download Full-text

ProTaper files in root canal preparation: Case report

Stomatoloski glasnik Srbije ◽

10.2298/sgs0504237b ◽

2005 ◽

Vol 52 (4) ◽

pp. 237-241 ◽

Cited By ~ 1

Author(s):

Tatjana Brkanic

Keyword(s):

Case Report ◽

Clinical Practice ◽

Root Canal ◽

Nickel Titanium ◽

Endodontic Treatment ◽

Root Canal Preparation ◽

Everyday Clinical Practice ◽

Rotary Instruments ◽

Canal Shaping

The aim of this paper was to, on the basis of everyday clinical practice, show and analyse, the crown-down technique of root canal preparation with nickel-titanium rotary instruments. After the diagnosis of irreversible pulp disease on the second lower right molar, endodontic treatment was carried out. Root canal shaping was performed with modified crown-down technique with nickeltitanium rotary files (ProTaper, Meilffer), according to the manufacturer?s recommendations. After root canal preparation, obturation was finished with AH26 and guttapercha points (.06 taper), using the lateral compaction technique.

Download Full-text

Astounding Root Canal Anatomy of A Manibular Second Molar – A Case Report

Indian Journal Of Applied Research ◽

10.15373/2249555x/sept2013/123 ◽

2011 ◽

Vol 3 (9) ◽

pp. 417-418

Author(s):

Dr Veerendra M Uppin ◽

◽

Dr Priyanka Sarangi ◽

Dr Sukanta Kumar Satapathy

Keyword(s):

Case Report ◽

Root Canal ◽

Second Molar ◽

Root Canal Anatomy

Download Full-text

Root Canal Treatment of A Maxillary Canine With Two Root Canals: a Case Report

International Journal of Scientific Research ◽

10.15373/22778179/aug2013/134 ◽

2012 ◽

Vol 2 (8) ◽

pp. 406-407

Author(s):

Dr. Ramta Bansal ◽

◽

Dr. Aditya Jain ◽

Dr. Ramta Bansal

Keyword(s):

Case Report ◽

Root Canal ◽

Root Canal Treatment ◽

Maxillary Canine ◽

Root Canals

Download Full-text

Retrieval of fractured Endodontic Instrument under dental operating microscope using ultrasonic tips : A Case Report

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2463 ◽

2020 ◽

Vol 11 (3) ◽

pp. 3316-3321

Author(s):

Samrudhi Khatod ◽

Anuja Ikhar ◽

Pradnya Nikhade ◽

Manoj chandak

Keyword(s):

Case Report ◽

Root Canal ◽

Fracture Resistance ◽

Root Canal Treatment ◽

Operating Microscope ◽

Severe Loss ◽

Mechanical Procedure ◽

Root Dentin ◽

Fracture Level

A Patient came with the complaint of pain in the lower right back region of the jaw. Root canal treatment was planned. While preparing for the bio-mechanical procedure, the Hand pro taper fractured in the apical third. Iatrogenic occurred as a result of the fracture of the endodontic instrument. Retrieval of the fractured instrument was planned to complete the cleaning and shaping of the canal. The removal of the fractured instrument was planned to be done under the Dental Operating Microscope. The use of an operating microscope enhanced the illumination and the magnification of the instrument. This illumination and magnification helped in the precision of removal. The ultrasonic tip enabled to reach of the fractured instrument in the canal and loosen the dentin around the fractured instrument. It allowed easy retrieval of the fractured instrument. During the retrieval procedure, the fractured instrument was bypassed before the use of the ultrasonic tip. After the removal of the fractured instrument, cleaning and shaping were completed, followed by obturation, definitive restoration, and prosthesis. As the removal of the fractured instrument enabled complete cleaning and shaping, it improved the prognosis of the case. When the endodontic instrument gets fractured, it should be analyzed over the radiograph to assess the fracture level, the anatomy of the root canal, size of the fractured instrument, check accessibility, stage of fracture, etc. If all the above criteria are met with the removal of the instrument only then, replacement should be tried. Otherwise, it may lead to a severe loss of root dentin, decreasing fracture resistance of the root.

Download Full-text