Dental Education Lecture: Curvy Root Canal

We discuss curvy root before (Fig.1).  Extraction of the tooth with curvy root should be difficulty.  Saving it will be more difficult, since the canal inside the curvy root is also curvy (Fig.2, the same tooth as Fig.1).  The file (F in Fig.2) we use to finish root canal is straight (Fig.3, left handed one).  To go through the curvy canal safely, the doctor needs to bend the file in the same curvy fashion beforehand (Fig.3 right handed one).  A lot of practice is mandatory in extracted teeth with curvy canal.  If practice is not enough and/or curvature is too complex such as S-shaped canal in Fig.6 (black arrowheads), file separation is a possibility (Fig.6 red arrowhead). 

Finally a patient with curvy canal asks for saving the tooth (Fig.4).  With experience particularly with frustration, caution and patience, root canal is almost done (Fig.5).

The separated file in the end of the canal is hard to retrieve (Fig.6).  If the majority of the nerve is taken out before the misfortune, the tinny tiny file inside the tooth should not do too much harm.  Most likely you have no pain physically.  If you do, we have a solution: removing the root tip with the separated file.

Xin Wei, DDS, PhD, MS 1st edition 02/27/2011, last revision 09/27/2012