Clinical identification and endodontic management of furcation canals: a case series.

In the case of endodontic infection, the presence of furcation canals can be at the origin of a periodontal lesion located in the furcation. The furcation being very close to the marginal periodontium, this type of lesion can be favorable to the genesis of an endo-periodontal lesion. These furcation canals are lateral canals located on the pulp chamber floor and constitute one of the many physiological communication pathways between endodontic and periodontal tissues. These canals are most often difficult to localize, shape, and to fill because of their small diameter and length. The disinfection of the pulp chamber floor with sodium hypochlorite solution may contribute to the disinfection of furcation canals when they are not identified, shaped, and/or filled. This case series illustrates the endodontic management of visible furcation canals associated with an endo-periodontal lesion. These furcation canals had a large diameter which allowed their identification during the endodontic treatment.

Clinical identification and endodontic management of furcation canals: a case series

Abstract In the case of endodontic infection, the presence of furcation canals can be at the origin of a periodontal lesion located in the furcation. The furcation being very close to the marginal periodontium, this type of lesion can be favorable to the genesis of an endo-periodontal lesion. These furcation canals are lateral canals located on the pulp chamber floor and constitute one of the many physiological communication pathways between endodontic and periodontal tissues. These canals are most often difficult to localize, shape, and to fill because of their small diameter and length. The disinfection of the pulp chamber floor with sodium hypochlorite solution may contribute to the disinfection of furcation canals when they are not identified, shaped, and/or filled. This case series illustrates the endodontic management of visible furcation canals associated with an endo-periodontal lesion. These furcation canals had a large diameter which allowed their identification during the endodontic treatment.

Resumo No caso de infecção endodôntica, a presença de canais cavo inter-radiculares pode estar na origem de uma lesão periodontal localizada na região de furca. Sendo a furca muito próxima do periodonto marginal, esse tipo de lesão pode ser favorável à fomação de uma lesão endo-periodontal. Esses canais estão localizados no assoalho da câmara pulpar e constituem uma das inúmeras vias de comunicação fisiológica entre os tecidos endodônticos e periodontais. Esses canais são na maioria das vezes difíceis de localizar, instrumentar e obturar por causa do diâmetro e comprimento reduzidos. A desinfecção do assoalho da câmara pulpar com solução de hipoclorito de sódio pode contribuir para a desinfecção dos canais cavo inter-radiculares quando eles não são localizados, instrumentamos e/ou obturados. Os casos clínicos descritos ilustram o manejo endodôntico de canais cavo inter-radiculares visíveis associados a uma lesão endo-periodontal. Esses canais cavo inter-radiculares tinham um grande diâmetro que permitiu sua localização durante o tratamento endodôntico.

Guided Endodontics in the Management of Intracanal Separated Instruments: A Case Report.

AIM: The aim of this case report is to describe the removal of a fractured file in mandibular right first premolar through the application of an endodontic template to guide a trephine until the file. BACKGROUND: The fracture of an endodontic instrument is a rare complication that requires therapeutic management. Removal procedures often cause excessive dentine loss. To limit this inconvenience, several techniques describing the removal of fractured files in the coronal third of the canal have been proposed. The guide facilitates the use of the Zumax removal kit (Zumax Medical Co. Ltd., Suzhou, China). CASE DESCRIPTION: A 30-year-old patient was referred to dental office for the endodontic retreatment of his mandibular right first premolar. The tooth was painful to percussion and buccal palpation. The periapical radiograph showed a periapical lesion, a defective root canal treatment, and the presence of a fractured file. It was decided to use the Zumax kit in order to remove the instrument. By using digital implantology software, a guide was constructed with a tube to guide a trephine and achieve straight-line access. The trephine was later driven by the resin guide. After completing the drilling, the instrument was removed with the Zumax extractor and the canal was then prepared, disinfected, and filled. CONCLUSION: The current case describes the removal of a separated instrument by use of a new approach that is planned on computer software and guided by a resin guide. CLINICAL SIGNIFICANCE: The guided endodontic technique avoids excessive loss of dental structure and simplifies the procedure by reducing chair time and increasing the operator's confidence.

Microguided endodontics: Accuracy evaluation for access through intraroot fibre-post.

In this work, we intended to assess the reliability of guided endodontic technique to remove a bonded fibre-post when there are artefacts in the cone-beam computed tomography (CBCT) images caused by composite dental materials. We mounted natural posterior teeth on ten simulated models. Forty fibre-post and composite-core restorations were inserted in the teeth. We merged a pre-operative CBCT and optical surface scan on the BlueskyplanTM software to digitally design and subsequently 3D-printed the guides. Two operators initiated endodontic access into the fibre-post restorations using the template to guide the drill. Post-operative CBCT was taken and merged onto the pre-operative plan to measure the deviations at the coronal and apical segments. The mean deviation between the planned and actual drill paths were, respectively, of 0.39 ± 0.14 mm coronally and 0.40 ± 0.19 mm apically. Microguided endodontics is a predictable and accurate method to remove fibre-post restorations efficiently.

Optimisation of a guided endodontics protocol for removal of fibre-reinforced posts.

This paper demonstrates the usefulness of endodontic guides for the removal of fibre posts. A 36-year-old man consulted for retreatment of a maxillary first molar presenting a periapical pathology. This tooth revealed a composite reconstruction together with a glass-fibre post in the palatal root canal. To assist removal, use of an endodontic 3D-printed guide was indicated. A cone beam computed tomography examination and an optical impression were made to produce a tooth-supported guide by means of implant planning software (Blue Sky Plan, Blue Sky Bio® ). The software enabled definition of a drilling pathway, which was transferred clinically using a resin template together with a sleeve and a 0.75-mm drill. The drill was guided as far as the gutta-percha situated in the apical third, limiting any risk of impairment or perforation.

Clinical Appraisal of the WAM'X Super Quick Post-and-Core Removal Device.

This report describes an innovative technique to remove post-and-core restorations. The WAM'X Super Quick post removal device permits a secure mechanical traction technique that can adapt to variable root angulations. Pivoting prongs mounted on forceps allow post removal while preserving the ferrule effect to improve resistance to fractures.