Instrumenting the calcified canal

Instrumenting calcified canals: A comprehensive, crown-down and step-down approach

Overview

This video focuses on the techniques for instrumenting calcified canals, one of the most complex scenarios in endodontic treatment. It begins by outlining the challenges these canals present due to their narrow, tapered morphology. It then presents a structured approach to canal preparation, providing a systematic strategy designed to enhance treatment precision and reduce the risk of complications.

Key topics covered

• Challenges of instrumenting narrow, calcified canal
• Step one: Using hand files to initiate canal access and scouting
• Step two: Coronally flaring to remove interferences
• Step three: Establishing a reproducible glide path
• Addressing the 10-15 size jump
• Bridging hand file use (size 12)
• Bridging rotary path file use (size 13/02)
• Achieving TruNatomy glide path (size 17/02v)

Clinical relevance

This approach allows the dentist to apply a controlled crown-down protocol that eases pressure on instrumentation, ultimately increasing the safety and efficacy of canal preparation.

Learning outcomes

By watching this video, dentists will be able to:

• Define the best methods to create conservative, controlled preparations with the appropriate instruments
• Discuss the value of stepwise instrumentation, with bridging files and hybridisation of systems when required
• Understand when to use hand files, NiTi files, and what features to look for in different files
• Assess methods to create a crown-down, step-down process for complex calcified canals