Endo resto treatment of a lower left molar with Harmony files
23/12/2024
Francesca Cerutti
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Curved canals can be difficult to manage because of the risk of creating ledges, wrong paths or to block the file inside of the curvature, with subsequent file separation.
A correct approach, together with a sequence of files combining good cutting efficiency and flexibility, can lead to a successful management of those cases.
Low taper files are recommended in order to preserve as much as possible sound dental tissue. The following case was managed by using 17/.04 , 22/.04 and 30./04 from the Harmony kit by FANTA dental.
A 29 years old patient came to my attention referring a history of pain and swelling in the lower left hemi-arch.
The x-ray showed a large decay on the distal aspect of tooth 3.6. At the clinical examination I found positive response to percussion and negative response to pulp sensitivity tests. I started removing the decayed tissue without rubber dam because I saw from the X-ray that the decay was extended and I wanted to see if crown lengthening was necessary.
Afgter removing completely the decay I assessed that it was possible to manage the case with deep margin elevation, so I positioned the rubber dam and a matrix and I build up the missing wall.
After that I started designing the access cavity and refined it with ultrasonic tips.
Bleeding could be noticed from the distal canal.
I started the shaping with Harmony 17/.04 used with a step down approach. I removed coronal interferences from the distal and the mesial canals.
I checked the WL with manual K-files
I took the 17/.04 again and I used it until the WL in all the canals, followed by 22/.04 and 30./04
With a this ultrasonic tip I shaped the isthmus between the mesial canals in order to remove debris and pulp remnants.
I irrigated, activated the irrigant and then filled the root canals with hydraulic sealer and gutta percha.
I immediately did the build up of the tooth and prepared for a composite overlay that was luted in the following appointment
Conclusions
Harmony kit seems effective in the treatment of teeth with curved canals
Bibliography
Plotino G, Ozyurek T, Grande NM, Gundogar M. Influence of size and taper of basic root canal preparation on root canal cleanliness: a scanning electron microscopy study. Int Endod J. 2018.
Sabeti M, Kazem M, Dianat O, Bahrololumi N, Beglou A, Rahimipour K, et al. Impact of Access Cavity Design and Root Canal Taper on Fracture Resistance of Endodontically Treated Teeth: An Ex Vivo Investigation. J Endod. 2018;44(9):1402-6.
Burklein S, Jager PG, Schafer E. Apical transportation and canal straightening with different continuously tapered rotary file systems in severely curved root canals: F6 SkyTaper and OneShape versus Mtwo. Int Endod J. 2016.
