This step-by-step video shows a predictable way to find a severely calcified canal.
This patient presented with a history of trauma to the maxillary anterior central incisors. Both teeth appeared to be severely calcified on the preoperative radiographs (Figure 1)
The following sequence is detailed in the video:
Initial access penetration with a #330 carbide bur just above the cingulum
Smoothing with a #2 round bur reveals the dark tertiary dentine (the calcified canal) (Figure 2)
Clearing with 17% EDTA maintains the perspective of the calcified dentine which should be penetrated at the most apical and lingual position
Deeper penetration with a small Munce bur alternating with a #2 round bur while constantly clearing with 17% EDTA
When a catch or "stick" is felt with an endodontic explorer, a small K-file may be placed. The value of a novel new pulp dehydrant (trichloracetic acid-based) is shown (Figure 3)
Progress is made down the natural canal space with patience (Figure 4)
The process is repeated with sequenced use of pre-curved files (recapitulations) and eventually the entire canal space is cleaned and shaped with patency established (Figure 5)
- Calcium hydroxide is place and a temporary is placed in the access cavity preparation (Figure 6)
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