Double Twisted Curves in #5

PathFile and WaveOne Navigate Curvatures

Clinician: Richard M. Bloom, DDS, Levittown, New York

Description of the tooth: Upper 1st Bicuspid (#5), 27 year old male.

Diagnosis: Pulpal necrosis.

The situation: Large carious lesion seen clinically and radiographically on tooth #5. The tooth was tender to percussion and painful to cold air and liquids. A periapical radiograph revealed two curves in each root of tooth #5. Both roots curved to the distal in a mesial/distal orientation and then they curved back into a buccal/lingual orientation.

The procedure: The patient was anesthetized using one carpule of 1:100K Lidocaine with epinephrine. The tooth was isolated with a rubber dam and tooth decay removed.

Once the canals were located they were initially navigated with PathFile files and sodium hypochlorite. Working lengths were established for both canals using an electronic apex locator and a #10 Lexicon K-Reamer. The canals were then initially hand instrumented with #10 & 15 Lexicon Hedstrom files. The final shape was completed using the WaveOne Primary file with copious sodium hypochlorite solution agitated in the canals using a 30-gauge ProRinse irrigation probe.

The canals were dried and then irrigated with QMix 2in1 irrigating solution and dried again. Final obturation was completed using a #25 GuttaCore obturator in the lingual canal and #25 Thermafil obturator in the buccal canal.

Editor’s note: Dr. Bloom noted that in multi-canal teeth he frequently uses GuttaCore in the canal where he intends to place his post and uses Thermafil in other canals.


Dr. Richard M. Bloom is a graduate from NYU Dental School and is a member of the American Dental Association, NYS and Nassau County Dental Societies, and Integrated Dental studies group. He has been practicing dentistry in Levittown since 1983. His general practice dental office specializes in cosmetic, laser and emergency dentistry.

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