Thank you, I have always been taught to precurve the file, but it nice to have a visual of how much I need to curve it, becuase just a slight bend at the tip might not help
hello Dr, thank you for your video, it is very informative. I just had root canal done today, my endodontist is very experienced, but my teeth is very difficult. He said my molar is calcified and one of my root canal is curved. So he said he put some medication on that canal and hopefully next time when I go back it will be easier.
Hi there. Thanks for the comment. That rock bottom feeling is SUPER frustrating! I'll have a few more tips that I've learned to get around that rock bottom feeling.
Hello Dr. I appreciate this informative video. I just had a root canal hours ago with the same type of curvature, so it was interesting to see what was just done on me. My endodontist is very experienced; however, I guess my tooth was challenging for him. It was my very back tooth and I have a small mouth which I cannot open wide very well (or for any length of time so they used a bite block.) At the tip of the root was infection, which was causing a small boil up at my gum line; whenever I pulled back my cheek to look at it in the past week, pus would ooze from it. Hopefully, my root canal will resolve that. I am experiencing throbbing pain and swelling in the tooth 4 hours later. This is probably normal due to the extended time spent on it (nearly two hours.) I have left an after-hours message for my endodontist but saw your video and that you have responded to questions, so I thought I would inquire about this. Thanks!
Thank you for your comment. I greatly appreciate your story and the time you took to share it with our community. What I normally tell patients is that the tooth will be painful to biting for the next 5-7 days. The area will also be tender/painful from the anesthesia as well. Furthermore, your jaw muscles will be sore from being open during the procedure. Unfortunately, some procedures take longer than others. With the advent of technology, root canal procedure times have decrease significantly. When I started (insert old person statement here...), it was 3 hour appointments x 3 times! That was crazy. Advil and tylenol together can help (as long as you don't have an allergy to either). Please let us know how it goes.
Hi Doc, i have face a several curve canal case in my daily practice. Sometimes i can go to the curve with precurved #6-#8-#10, but when i turn to the rotary file i lost my glide path (or the rotary file wont follow the curve that i made with the #6-10 sequence), what is your suggestion? Thank you Doc
Hi Nick - I know EXACTLY what you mean. you're good to go with hand files, but then that rotary file won't make it around the curve. In my experience, you have a few options. 1. Determine how far away that bend is from either the apical constriction and/or joining another canal - and decide if it's worth pulling your hair out with trying to finish with a rotary file - or - just handfile that last 1mm of the canal with precurved handfiles (up to maybe a #20). Ive done this several times when that last bend is only 1mm away from my final working length. 2. Get a super flexible file - I prefer reciprocating files (wave one gold) for a whole list of reasons, but - when i used to use protaper next and I used the pro-glider - those files would NOT make it around curves sometimes and it would drive me batty. If you don't have reciprocating, I'd recommend a super heat treated file like protaper gold, hyflex or my favourite rotary - vortex blue - they are super flexible and might make your life easier by getting around that curve 3. Develop your glidepath with precurved handfiles to a #15, and #20 - and don't use a crown down (rotary files) technique in these cases - i'd use a 15.06 vortex blue to make your way around that curve, then work upwards in this pattern: 15.06, 20.04, 25.04, 30.04 4. OPen the coronal 2/3rds of your canal first, then tackle the apical 3rd. So, if you're using a constant tapered file, open the coronal 2/3rds to a 25.04, irrigate lots, then start tackling the apical third after that. 5. Dr. McSpadden has talked about the zone technique - check it out here: nanoendo.com/blog/tag/zone-technique/ hope this helps! Ash
We used to live in Belgium! I was posted there to Mons. We used to live on Rue Brissee. Many amazing memories of Belgium (including our 2 oldest sons who were born there). I worked at SHAPE.
@E .S Thanks for the comment. This is SUCH an important topic that I will present you with what I've been taught in the next weeks. In short, I'd have to say that I've moved away from using a #25 file in curved canals b/c I"ll ledge that canal 100% with that file. I think what would be more efficient to show would be getting a smooth glide path to a #10 file and then taking a small rotary file (depending on what country you live in and what is available) and precurving it (cooling it with endo ice can help keep the bend), and sneaking it past the curve by hand, and then either connecting it to a rotary handpiece, or using the balanced force technique to handfile it. I"m excited to show you!
Hi there, Thank you for your comments. Your English is great! I do use Wave One and will be demonstrating my technique that I use (I've honed this technique over the past 3 years).
I'm doing mandibular 6 , it has distally curved mesiobuccal canal, I tried this thing what you just demonstrated above but not helping. I'm using #6 kf-file. I had precurved it, used EDTA,still it doesn't go past the curve in the canal.
Hafsa Akhtar Hi there. I know what you mean. 2 questions. Is the case vital? Are you close to complete working length? You may be dealing with an acute apical Curve and if the case is vital, and you’re close to complete working length (as per a working length radiograph), you may be able to finish the case and have success- if it’s vital. If it’s necrotic, you can place calcium hydroxide and reappt to see if you can use bird beak pliers to get past that apical curve - or refer.
@@AllThingsDentistry it was a non viral case, my working length was 23mm but it wasn't going past 19mm, I called the senior , they tried to go past 19mm too but it didn't help. Since it was patients 4th visit( due to time management on patients part) and he was not having pain so the senior told me to obturate at 19mm. Should I go for it? Patient is still not having pain though.
@@hafsaakhtar6113 I'd have agree. At some point, you have to make a decision. I have seen cases survive for years after a short fill (usually vital). Are you able to refer to an endodontist or are you in dental school?
Hello Dr. I went to have a root canal on my crown tooth today and my endodontist could only remove 2 out 3 roots canal from my tooth #14, she said the 3rd root is too curved and she was not able to get the file in and suggested I might have a surgery for that tooth. Does it make any sense to you Dr? And what do you suggest me to do? I hope you can answer me. Thank you!
All the cases are different and we can not tell so untill the radiograph is not there. But if she's an endodontist its her duty to work with as tough canal as it could be and suggesting surgery/extraction should be the last option.
Please give an in depth explanation pls. Today i had a patient who needed an RCT for tooth 27 (FDI system) tooth 15 for those using the universal system. Anyway, the patient on top of having curved canals also had a minimal mouth opening and very small canals that even yhr no 10 file couldnt reach the apex for working length. 😭
Ehm Penalba OMG. I know that feeling. One thing you can try is cycling 21mm files in this order. : #6,#8, then #10 - then back to #6 file, then 8, then 10. Try watch winding each file about 3 times each and then switch to the next file. That has SUPER helped me. That’s on the list to capture video
Doc I followed your steps and was able to get past the curve. Thank you so much
This really works.
Easy to say hard to do. Who conquers curved canals, is a master for me
Thank you, I have always been taught to precurve the file, but it nice to have a visual of how much I need to curve it, becuase just a slight bend at the tip might not help
Hey MZZ! Thanks for the comment. I"ll have a few more posts about how to bend the tip of the file in seriously curved canals.
@@AllThingsDentistry Sweet!
All Things Dentistry did you post any video about bending the file? 😁
All Things Dentistry should we pre-bend 1 mm at the tip or like you have done in this video?
hello Dr, thank you for your video, it is very informative. I just had root canal done today, my endodontist is very experienced, but my teeth is very difficult. He said my molar is calcified and one of my root canal is curved. So he said he put some medication on that canal and hopefully next time when I go back it will be easier.
Good job dr ... Srsly that's most annoying feeling to hit rock like stop ... Thanks for unidirectional rubber stopper idea .
Hi there. Thanks for the comment. That rock bottom feeling is SUPER frustrating! I'll have a few more tips that I've learned to get around that rock bottom feeling.
All Things Dentistry it's would be nice to share .... Thanks in advance
Nice trick with notch of rubber stopper
Hello Dr. I appreciate this informative video. I just had a root canal hours ago with the same type of curvature, so it was interesting to see what was just done on me. My endodontist is very experienced; however, I guess my tooth was challenging for him. It was my very back tooth and I have a small mouth which I cannot open wide very well (or for any length of time so they used a bite block.) At the tip of the root was infection, which was causing a small boil up at my gum line; whenever I pulled back my cheek to look at it in the past week, pus would ooze from it. Hopefully, my root canal will resolve that.
I am experiencing throbbing pain and swelling in the tooth 4 hours later. This is probably normal due to the extended time spent on it (nearly two hours.) I have left an after-hours message for my endodontist but saw your video and that you have responded to questions, so I thought I would inquire about this. Thanks!
Thank you for your comment. I greatly appreciate your story and the time you took to share it with our community. What I normally tell patients is that the tooth will be painful to biting for the next 5-7 days. The area will also be tender/painful from the anesthesia as well. Furthermore, your jaw muscles will be sore from being open during the procedure. Unfortunately, some procedures take longer than others. With the advent of technology, root canal procedure times have decrease significantly. When I started (insert old person statement here...), it was 3 hour appointments x 3 times! That was crazy. Advil and tylenol together can help (as long as you don't have an allergy to either). Please let us know how it goes.
Which singal rotary file system is best for such curved canal
Great video as usual ! Question: instrument do you normally use to safely curve your K-files ?
Hi Doc, i have face a several curve canal case in my daily practice. Sometimes i can go to the curve with precurved #6-#8-#10, but when i turn to the rotary file i lost my glide path (or the rotary file wont follow the curve that i made with the #6-10 sequence), what is your suggestion? Thank you Doc
Hi Nick - I know EXACTLY what you mean. you're good to go with hand files, but then that rotary file won't make it around the curve. In my experience, you have a few options.
1. Determine how far away that bend is from either the apical constriction and/or joining another canal - and decide if it's worth pulling your hair out with trying to finish with a rotary file - or - just handfile that last 1mm of the canal with precurved handfiles (up to maybe a #20). Ive done this several times when that last bend is only 1mm away from my final working length.
2. Get a super flexible file - I prefer reciprocating files (wave one gold) for a whole list of reasons, but - when i used to use protaper next and I used the pro-glider - those files would NOT make it around curves sometimes and it would drive me batty. If you don't have reciprocating, I'd recommend a super heat treated file like protaper gold, hyflex or my favourite rotary - vortex blue - they are super flexible and might make your life easier by getting around that curve
3. Develop your glidepath with precurved handfiles to a #15, and #20 - and don't use a crown down (rotary files) technique in these cases - i'd use a 15.06 vortex blue to make your way around that curve, then work upwards in this pattern:
15.06, 20.04, 25.04, 30.04
4. OPen the coronal 2/3rds of your canal first, then tackle the apical 3rd. So, if you're using a constant tapered file, open the coronal 2/3rds to a 25.04, irrigate lots, then start tackling the apical third after that.
5. Dr. McSpadden has talked about the zone technique - check it out here: nanoendo.com/blog/tag/zone-technique/
hope this helps! Ash
@@AllThingsDentistry Wow Thank You for your support Doc, i will try your option tips 👍🙏, keep posting. Do you have any social media(instagram)?
Have you started with heroshaper hand files or Mani k files?
As usual ....thanks sir ❤
Need a more detailed vedio on this topic
Absolutely. Thank you so much for your response. I will have more table top explanations and then clinical cases. Every damned case is so different!
@@AllThingsDentistry Yes, please I'll be also interested in a more detail explanation of the topic. Thank you. Belgium😀
We used to live in Belgium! I was posted there to Mons. We used to live on Rue Brissee. Many amazing memories of Belgium (including our 2 oldest sons who were born there). I worked at SHAPE.
@E .S Thanks for the comment. This is SUCH an important topic that I will present you with what I've been taught in the next weeks. In short, I'd have to say that I've moved away from using a #25 file in curved canals b/c I"ll ledge that canal 100% with that file. I think what would be more efficient to show would be getting a smooth glide path to a #10 file and then taking a small rotary file (depending on what country you live in and what is available) and precurving it (cooling it with endo ice can help keep the bend), and sneaking it past the curve by hand, and then either connecting it to a rotary handpiece, or using the balanced force technique to handfile it. I"m excited to show you!
@@AllThingsDentistry it's a small small world😂 Am a student in Brussels(Ulb). We do a period of clinical training in Mons too.
Hi! Tell me please, are you using Wave One system and which your reviews for that? Sorry for my bad English:)
Hi there,
Thank you for your comments. Your English is great! I do use Wave One and will be demonstrating my technique that I use (I've honed this technique over the past 3 years).
钙化根管该如何处理，谢谢老师！
Sir,can we use rotary immediately in such cases after hand filing with 2%
Have had moments where I need to pre-bend a handfile to get to apex, but can’t get a rotary file to follow. Any tips?
Rajeev De Silva absolutely. I have a few that I’ve been taught. It’s definitely easier to show than to talk about. Give me a week or so
I'm doing mandibular 6 , it has distally curved mesiobuccal canal, I tried this thing what you just demonstrated above but not helping. I'm using #6 kf-file. I had precurved it, used EDTA,still it doesn't go past the curve in the canal.
Hafsa Akhtar Hi there. I know what you mean. 2 questions. Is the case vital? Are you close to complete working length? You may be dealing with an acute apical
Curve and if the case is vital, and you’re close to complete working length (as per a working length radiograph), you may be able to finish the case and have success- if it’s vital. If it’s necrotic, you can place calcium hydroxide and reappt to see if you can use bird beak pliers to get past that apical curve - or refer.
@@AllThingsDentistry it was a non viral case, my working length was 23mm but it wasn't going past 19mm, I called the senior , they tried to go past 19mm too but it didn't help. Since it was patients 4th visit( due to time management on patients part) and he was not having pain so the senior told me to obturate at 19mm. Should I go for it? Patient is still not having pain though.
@@AllThingsDentistry BTW thank you for your response!
@@hafsaakhtar6113 I'd have agree. At some point, you have to make a decision. I have seen cases survive for years after a short fill (usually vital). Are you able to refer to an endodontist or are you in dental school?
Hello Dr. I went to have a root canal on my crown tooth today and my endodontist could only remove 2 out 3 roots canal from my tooth #14, she said the 3rd root is too curved and she was not able to get the file in and suggested I might have a surgery for that tooth. Does it make any sense to you Dr? And what do you suggest me to do? I hope you can answer me. Thank you!
All the cases are different and we can not tell so untill the radiograph is not there.
But if she's an endodontist its her duty to work with as tough canal as it could be and suggesting surgery/extraction should be the last option.
Can we use niti files is pre curving becomes difficult?
Hi Jamie. Thank you for your question. Absolutely - you can use whatever you have to get down that root!
Are those C files from dentsply ?
Yes.
Please give an in depth explanation pls. Today i had a patient who needed an RCT for tooth 27 (FDI system) tooth 15 for those using the universal system. Anyway, the patient on top of having curved canals also had a minimal mouth opening and very small canals that even yhr no 10 file couldnt reach the apex for working length. 😭
Ehm Penalba OMG. I know that feeling. One thing you can try is cycling 21mm files in this order.
: #6,#8, then #10 - then back to #6 file, then 8, then 10. Try watch winding each file about 3 times each and then switch to the next file. That has SUPER helped me. That’s on the list to capture video
Try this out! th-cam.com/video/RuBSBbQy-8A/w-d-xo.html
That's a C file 😍
My favourite! and presterilized as well!
Haidar alhaddad Brand ?
Probably should use a file without debris on the tip
Why use C file instead of K file
Make video on EdgeEndo files... Its awesome files
I've only used them once. Which kind are you using?
Curved canals i hate them😷