The hunt for the hidden – Methods of locating root canals

Abstract

Predictable endodontic therapy begins with good access preparation, which allows for the accurate location of any given orifice, facilitating the negotiating, securing, and shaping of the canal, as well as 3D disinfection and filling of the root canal system. Missed, unfilled, and untreated root canals have been identified as one of the leading causes of endodontic therapy failure in several investigations. With the advent of CBCT, magnification, ultrasonics and other diagnostic and treatment adjuvants, searching for and treating root canals has become easier and more predictable.

Management missed canal tooth and broken file using ultrasonic instrument

“…6 Therefore, clinicians must use effective strategies for locating canals; these strategies are dependent on the clinicians' knowledge of tooth anatomy, ability to interpret radiographic data; proficiency in performing cone-beam computed tomography (CBCT), magnification, and illumination; access cavity preparation skills; and proficiency in using ultrasonic devices, dyes, and disinfectants, such as sodium hypochlorite (NaOCl). 7 Instrument separation, especially when using endodontic files, is a common mishap that occurs during endodontic treatment; it causes root canal obstruction and inhibits the process of shaping and cleaning. Using nickel titanium (NiTi) rotary instruments during root canal preparation does not reduce the risk of separation because this instrument is often overused or used incorrectly.…”