← Back

Finding a Severely Calcified Canal

Terry Pannkuk, DDS, MScDInstructional, Complications: Advanced Management, Calcification, Sample Cases, All by Date

Video Description

Figure 6. Periapical radiograph showing placement of calcium hydroxide

Description

Figure 1. Preoperative periapical radiograph

Description

Figure 2. Identification of the calcified canal space

Description

Figure 3. Use of a novel pulp dehydrant

Description

Figure 4. Deeper penetration of the true canal space

Description

Figure 5. Peripaical radiograph showing patency achieved

«
Play Video
»
Prev 1 Next

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)

Join the discussion

You must log in or create a free account to post a comment.