Endodontic treatment of the teeth with different root canal curvatures: Two case reports

Abstract

Endodontic treatment of the teeth with severe root canal curvatures has become one of the greatest problems in clinical practice. Recently, new instruments and techniques have been introduced in the endodontic procedure. The aim of this study was, on the basis of clinical practice, to show the possibilities of the endodontic treatment in the teeth with severely curved root canals, after dependable decision about endodontic instruments and techniques. This article presents a complete endodontic procedure in two teeth with different curvature shape of the root canal in patients that were treated at the Department of Restorative Dentistry and Endodontics, School of Dentistry, Belgrade. Coronal to apical 'crown down' technique was used for the root canal preparation with hand NiTi ProTaper instruments with progressive multicone design. The main reasons for choosing manual technique were complexity, shape of presented curvatures and better tactile sensation control of canal instruments in order to avoid possible mistakes and complications. Clinical X-rays of the teeth with permanent obturation clearly showed that extremes of the root canal morphology could be successfully solved by the right choice of all factors during endodontic procedure.

Endodontsko lečenje zuba s jako zakrivljenim korenovima je značajan problem u praksi. Primena novih instrumenata i tehnika u lečenju ovakvih zuba poslednjih godina je postala sve izvesnija.Cilj ovog rada je bio da se na primerima iz kliničke prakse ukaže na mogućnost endodontskog lečenjazuba s veoma izraženim krivinama kanala korena nakon pravilnog izbora endodontskih instrumenata, odnosno tehnike instrumentacije. U ovom radu je prikazan celokupni endodontski postupak lečenja dva zuba pacijenata Klinike za bolesti zuba Stomatološkog fakulteta u Beogradu sa različitim oblicima krivine centralnog korenskog kanala. Prime-njena je krunično-apeksna 'crown-down' tehnika preparacije uz korišćenje ručnih nikl-titanijumskih instrumenata tipa ProTaper s progresivnom multikoničnošću. Osnovni razlozi za odabir ručne tehnike preparacije bili su složenost morfologije, oblik prikazanih krivina i bolja taktilno-senzorna kontrola kanalnih instrumenata; cilj je bio da se izbegnu moguće greške i komplikacije. Prikazani radiografski snimci zuba sa jasno opturiranim kanalnim sistemom pokazuju da su i ekstremi morfološkog izgleda kanala rešivi pravilnim odabirom svih činilaca endodontske procedure. .