Mastering curved canals: Assessment, instrumentation, and problem solving

Overview

In this live stream, we're discussing the complexities of managing curved root canals. We begin by assessing different types of curvatures using radiographic examples, emphasising not just the angle but also the radius and location of the curve. We then look at specific instrumentation protocols and file systems (like TruNatomy, ProTaper Ultimate and WaveOne Gold) we recommend for navigating these challenging anatomies safely and efficiently. We also review and offer guidance on our premium members cases and help answer their questions and problems.

Key Topics Covered

• Assessing root canal curvature using radiographs, considering the angle, radius, and location (coronal, mid-root, or apical) of the curve
• The importance of coronal flaring, especially when dealing with early coronal curvatures, to reduce stress on instruments
• Glide path management in curved canals, discussing the use of hand files (size 8, 10, C-pilot) and rotary glide path files (e.g., Pathfile and TruNatomy Glider)
• Specific rotary file systems suitable for curved canals, such as ProTaper Ultimate and TruNatomy, highlighting their design features (e.g., heat treatment, variable taper, flexibility)
• Strategies for avoiding procedural errors like ledging and transportation in curved canals, including detailed technique and appropriate instrument selection
• The concept of "pragmatism" in choosing both your approach and instruments and the potential for hybridising systems to achieve the best outcome for a specific case
• A look at your cases with a conversation on managing the open apex, removing that last bit of GP that won't come out and how can we obturate irregular anatomy.

Clinical Relevance

This session provides invaluable insights into the practical management of curved root canals, a common challenge in daily endodontic practice. By understanding how we assess different curvatures and select appropriate file systems and techniques, clinicians can improve their ability to negotiate these canals safely, minimise procedural errors, and achieve more predictable treatment outcomes.

Learning Outcomes

After watching this, dentists should be better able to:

• Analyse radiographs to accurately assess the complexity of root canal curvatures
• Select appropriate hand and rotary instruments, including glide path files, for managing various types of curved canals
• Apply techniques to minimise the risk of procedural errors such as ledging, transportation, and instrument fracture in curved canals
• Understand the rationale behind choosing specific file systems based on their design and the anatomical challenges presented and that sometimes a system cannot do it all.