Managing the s-shaped canal

Navigating s-shaped curvatures: An endodontic guide to complex canal anatomy

Overview

This video explores the challenges of treating teeth with S-shaped root canal curvatures. It stresses the importance of initial coronal enlargement, appropriate file selection, and step-by-step instrumentation to minimise torsional stress on instruments and prevent complications.

Key topics covered

• Identifying s-shaped curvatures
• The importance of variable taper files to avoid locking and excessive contact points within the canal
• Understanding the role of a small D16 measurement in minimising canal stripping
• Selecting file systems that offer a gradual step-down approach, including files that help bridge between coronal enlargement and the finishing file
• Using heat-treated files with good torsional fatigue properties to improve resistance to breakage
• Managing the coronal curvature by working more on one side to "soften" the transition and re-locating the coronal curvature to reduce the torsional load
• Implementing extra steps and transitional files to reduce torsional load on instruments

Clinical relevance

S-shaped canal configurations represent a significant risk for instrument fracture and incomplete cleaning. This video details a specific approach involving coronal enlargement and a step-down filing technique designed to reduce instrument stress and allow for controlled access and debridement of the entire canal system.

Learning outcomes

• Dentists will be able to recognise and assess s-shaped canal anatomy
• Dentists will understand the critical factors for file selection when treating complex curvatures
• Dentists will be able to modify their instrumentation technique to relieve stress on endodontic files
• Dentists will be able to implement a systematic step-wise approach to safely negotiate s-shaped canals