Finding a Severely Calcified Canal

Terry Pannkuk, DDS, MScD Instructional, Complications: Advanced Management, Calcification

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:

  1. Initial access penetration with a #330 carbide bur just above the cingulum

  2. Smoothing with a #2 round bur reveals the dark tertiary dentine (the calcified canal) (Figure 2)

  3. Clearing with 17% EDTA maintains the perspective of the calcified dentine which should be penetrated at the most apical and lingual position

  4. Deeper penetration with a small Munce bur alternating with a #2 round bur while constantly clearing with 17% EDTA

  5. 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)

  6. Progress is made down the natural canal space with patience (Figure 4)

  7. 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)

  8. Calcium hydroxide is place and a temporary is placed in the access cavity preparation (Figure 6)

Back to All Cases

Join The Discussion

0 comments

Commenting Guidelines Please make scholarly cited references or expert opinions suitable for publication. The comments can either be "pro" or "con" with references to the treatment philosophy. We encourage objectivity and detailed demonstration of knowledge/literature.
You must log in or create a free account to post a comment.

Related Cases

Endodontic Radiography Technique: Video Instructional Instructional, Clinical Endodontic Technique Instruction, Diagnosis
Heroic Retreatment of a Retreatment: Puzzle Case Part 2 Instructional, Complications: Advanced Management, Fractured Roots, Retreatment Strategies, Dismantling, Gutta Percha Removal, Recall Observations
Hidden Missed Canal Diagnosis, Access, Cleaning and Shaping, Complications: Advanced Management, Missed Canals, Retreatment Strategies
UPDATE RECALL-Retreatment of Surgical Resorption Repair Instructional, Complications: Advanced Management, Resorption Management, Recall Observations
20 year Recall of a Molar Tooth Having a Crown-Root Fracture Complications: Advanced Management, Fractured Roots, Recall Observations
Complex Anatomy-Fused DB-P and MB-P Roots Instructional, Cleaning and Shaping, Obturation