Endodontic treatment of mandibular premolar with 3 degree bend.
Autor: Ms. Vitor Hugo | Publicado: 2010-11-15T07:33:00-08:00

 The  chemical-surgical preparation is aimed at modeling and sanitation,  making use of endodontic instruments and auxiliary chemicals  instrumentation, working in the root canal system, organic and inorganic  structure, providing cleaning and disinfection of the space previously  occupied by the pulp, as also continuous conical conformation with  higher cervical diameter and smaller apical foramen in keeping the  original shape and position, facilitating the realization of the tight  seal and three-dimensional (shilder, 1974).   The complexity of the internal anatomy  (PINEDA, VERTUCCI, Weiner, HESS, BRAMANTE) and distribution of  microorganisms (Shovelton) constitute one of the biggest challenges of  Endodontics, especially when related to the curved canals.  NNevertheless, concrescence, crevices and atresias  are usually part of the peculiarities of the molars, especially the  curved (Schneider).   However, free access to the critical zone of the instrument and the  apical canal preparation is a procedure covered with difficulties, which  most often result in accidents, among others, excessive wear in the  danger zone, with or without perforation (ABOU-RASS ), hourglass-shaped  canal, with a smaller diameter in the middle portion of the channel  (Buchanan), steps, during apical preparation with or without perforation  (Al-Omari; SOUTHARD), besides the possibility of fracture of  instruments, due to tensions provided by the bends, as well as diameter,  tip design, flexibility of the instrument and instrumentation technique  used, variations in the hardness of dentin and obstructions of the  channel through the zest of dentin and consequently loss of working  length, signal the failure of therapy endodontic.   Many researchers have developed over the last two decades, variations in  technical preparation of curved canals from anatomical considerations  and their impact described above, with special attention to the  technique of cervical ripening (MARSHALL, PAIVA; LOPES).  The cervical ripening may  be defined by expanding the diameter at the entrance and the cervical  canal, creating a straight access to the middle and apical regions,  providing a wear anticurvatura, directed to the areas large or security  zones. Consiste numa alternativa para superar a influência da curvatura apical, a partir do desgaste compensatório. It consists of an alternative to overcome the influence of apical curvature, from the wear compensation.   It is the proposition of the authors present a simplified technique for  preparing curved canals, using techniques capable of overcoming  problems related to the presence of bends and difficulties. (In: SIMPLIFIED TECHNIQUE FOR THE PREPARATION OF CURVED CHANNEL) 

Case Study: 
History: Male, 52 years. Came to the clinic with pain, reporting possible fracture of the element 35. On clinical examination revealed a vertical fracture of  the crown, bevel, involving the crown of the middle to the vestibular  sense lingual vestibule. We observed&nbsp; the coronal pulp exposed. 
 Radiographically,  was observed on radiographs radiolucent area at the crown and a sharp  bend at the root of the element 35 in the region of middle. 
 Proposed treatment: endodontic treatment in one session. 

    Rotary instrumentation: Files Easy Pro-designate 20/03.  Biomechanics Final: Flexofile 25.   Hypochlorite solution with 5.25%.   
Obturation technique: Technique of warm vertical condensation (Schilder 1967). 
Endodontic sealer: Endofill (Dentsply)