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ePaper created 2016-01-20, 13:53:08 | version 1.38.0
18 I I case report _ root canal position and anatomy complications _Anatomy and nature still teach us on a daily basis. Root canal treatment, while it is becoming a routine procedure, surprises and sometimes bad cases still occur. In this article, I will present two unusual case reports from my own practice. _Case 1 The first is a clinical case that in my experience posed rather a challenge. The patient was referred to my office suffering from paraesthesia of his lower lip on the one side after a root canal treat- menthadbeenperformedonhismandibularsecond molar. The preoperative radiograph (Fig. 1), which was sent by his dentist, showed a well-per- formed root canal treatment that did not explain the clin- ical manifestations, but looking closely at the apical part one could observe that the obtu- ration material lay in proximity to the apex of the mandibular canal. Immediate retreatment wasrequired.Unfortunately,the material that had been used wastheplasticcarrierThermafil (DENTSPLY), and it was extend- ing into the nerve, causing the inflammation, and the inflam- mationwascausingpressureon thenerve.TheThermafilwasremovedfromthecanals— never an easy thing to do—using K3XF files (Sybron- Endo; Fig.2)andwithoutanysolventinordertoavoid any more damage to the nerve in case of leakage. I set theElementsAdaptiveMotor(KerrEndodontics;Fig.3) to K3XF mode, first using a 25.06 file in the softened part of the gutta-percha with the System B plugger. Iwasverycarefulnottopushthecarrierfurtherinside thenerveandnottodamagetheplasticcarrierandlose the grip. The second file used was the 25.04 K3XF to removemoregutta-perchaandtoliberatethecarrier. Theinstrumentwasusedtoholdthecarrierandto remove it from the canal (Fig. 4). Once the Thermafil roots1_2015 Getting to the 00.00 point Author_ Prof. Philippe Sleiman, Lebanon Fig. 1 Fig. 2 Fig. 3 Fig. 4