Present status and future directions: Management of curved and calcified root canals

Abstract

Root canal curvature and calcification introduce factors that increase the risk of procedural accidents during root canal treatment. The inability to achieve patency to the apical third, asymmetrical dentine removal leading to transportation, perforation, and instrument fracture inside the curved trajectories are some of the procedural problems that might jeopardize the management of intraradicular infection and result in poor treatment outcomes. In fact, curved and constricted canals introduce such complexity that total instrumentation concepts and specially designed instruments have been developed to deal with the challenge. This narrative review seeks to provide and consolidate the principles necessary for understanding the dynamics of curved and constricted canal management and to improve the understanding for future developments in this field.

Microcomputed tomography analysis of curved root canal preparation when coronal flaring and glide path files used with heat-treated nickel titanium rotary files

“…Curved root canals are a challenging experience for dental practitioners, and treatment mishaps are often common in these canals [ 2 , 3 ]. The root canal angle and radius of curvature are one of the main factors considered when evaluating the difficulty of root canal treatment RCT [ 8 ]. One of the main recommended techniques to shape curved root canal anatomy is to follow the traditional concept of the anti-curvature technique and crown-down technique [ 5 , 6 ].…”

“…This technique requires the clinicians to establish straight-line access to the mid-root to allow free access to the curvature in the coronal third [ 5 , 6 ]. A further recommendation was to use small K-files in sequence to the root terminus to create a glide path for larger rotary NiTi files [ 8 , 14 , 15 ]. The glide path is a crucial step to prevent blockage of the curved root canal system.…”

“…The glide path is a crucial step to prevent blockage of the curved root canal system. Since motor-driven rotary NiTi files are more efficient in creating the glide path, in comparison to manual K files, small-sized glide path rotary files were developed [ 8 , 14 , 15 ]. These files can be used after size 10 K files and before the use of rotary file systems [ 8 , 14 , 15 ].…”

Endodontic management of curved canals in mandibular molars- A case series

“…The disadvantages include the increased risk of torsional stresses and hence the torsional failure when engaged inside the anatomy, the reduced tactile sensation, the additional cost and the limitation of their use only after preparing intial glide path with the hand files. 10 In the present case series, small handfiles were first precurved and then placed inside the canal using reciprocating handpiece. Precurving of handfiles and use of smaller number files facilitates easy negotiation of canal curvature 11 and preserve root canal anatomy without any procedural mishap.…”

Endodontic Treatment of Two Calcified Mandibular Central Incisors: A Case Report

“…However, the presence of pulp canal calcification can complicate these procedures, challenging the effectiveness of the treatment by restricting access and complicating the cleaning and shaping process. This makes the management of calcified canals a critical aspect of successful root canal treatment [ 4 , 5 ].…”