Tight Spaces on #3

Tight Spaces Call for ProTaper Gold

“Because of the unique anatomy of the canal systems, I wanted to ensure that each system was properly negotiated to patency in order to obtain the proper glide path for the ProTaper Gold files.”

Joseph Bernier-Rodriguez, DDS
Virginia Beach, VA


Chief complaint: The patient presented with complaints of sensitivity to cold and biting pain.

Exam: Tooth #3 exhibited an increased response from percussion, biting and cold. There were extensive caries on the clinical crown of #3. The tissue was healthy and stable without pocketing.

Diagnosis: Symptomatic Irreversible Pulpitis with Symptomatic Apical Periodontitis

Treatment recommendation: Root canal therapy on tooth #3.

Treatment: Anesthetic was administered: 1.8 ml 3% Mepivacaine and 1.8 ml 4% Articaine 1:100,000 epi administered for buccal infiltration. A rubber dam was then applied to isolate the tooth. Occlusal access and caries removal were performed. Once the chamber was entered, a Pulp Shaper Bur was used to obtain proper visualization and straight line access to all canals.

A root canal conditioner was placed in the chamber and all canals were scouted with #8 and #10 Lexicon K-Files. To determine proper working lengths, an electronic apex locator was utilized. The working lengths were 19 mm for the MB1, 18.5 mm for the MB2, 17 mm for the DB and 21 mm for the P canals.

Once working length was obtained, each canal system was hand instrumented to a size 15 Lexicon K-File. When using the hand instruments, a combination of a root canal conditioner and 6% sodium hypochlorite was used to clean the canal space.

After establishing a glide path, ProTaper Gold rotary files were used to obtain proper canal shape in all canals in the following sequence with the use of sodium hypochlorite (6 %):

  • ProTaper Gold S1 was taken to the apex and used in a brushing motion.
  • ProTaper Gold S2 was taken to the apex and used in a brushing motion.
  • ProTaper Gold F1 was taken to the apex and removed.

After shaping was completed, all canals were irrigated using NaOCl (6%) and EDTA. As a final rinse, QMix 2in1 irrigating solution was used to remove the smear layer and bacteria. To further prepare the canals for obturation, sealer was place into each canal. Obturation was completed using a continuous wave warm vertical technique.

Upon completion of the root canal treatment, the case required a full build up and cuspal coverage crown.


“Because of the unique anatomy of the canal systems, I wanted to ensure that each system was properly negotiated to patency in order to obtain the proper glide path for the ProTaper Gold files.”


Dr. Joseph Bernier-Rodriguez is a published researcher and internationally recognized lecturer in the field of endodontics. He graduated with a Doctor of Dental Surgery degree from the Virginia Commonwealth University School of Dentistry in 2002. Upon graduation, he served in the United States Army for nine years as a dental officer. During his service in the Army, Dr. Bernier-Rodriguez completed his specialty training in endodontics where he received a Certificate in Endodontics.

In 2010, Dr. Bernier-Rodriguez became a Diplomate of the American Board of Endodontics. He currently maintains a private practice in Virginia Beach, VA.

 

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