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ePaper created 2017-06-21, 10:00:36 | version 1.38.0
Fig. 14 down into the canal by the slightly melted gutta- percha on top. The fi ne white line in the postoperative radio- graph of tooth number 45 showed the obturated small lateral canal leading away from the main ca- nal (Fig. 10). Moreover, in the follow-up session, we noted that healing of the affected teeth 45 and 46 had already taken place. The bioactive components of the obturation material further added to the regeneration process, as they stim- ulated the rebuilding of bone and dentine tissue, which was a favourable side effect to the actual sealing of the canal (Fig. 11). Case 3: Severe double curvature to fi nish off Last but not least, we come to the extraordi- nary S-shaped canal as mentioned in the in- troduction. With strong curves it is always good to know that NiTi fi les with a so-called “controlled memory” (CM) effect can be pre- bent like classic stainless steel fi les, but do not bounce back. Using their unique material prop- erties, you can work comparatively stress-free, even under diffi cult conditions. This time, the patient with the rather chal- lenging canal anatomy was a 40-year-old fe- male patient with complaints in her right side mandible. In our analysis, the clinical diagnosis revealed an irreversible pulpitis in tooth 47. The radio- graph indicated that we needed to get around a very sharp angle in the mesial root (Fig. 12); endo special- ists know how distant molars are notorious for their winding root canal system! We used the following sequence to get to the length very quickly without straightening the canal at all: HyFlex EDM 25/.12, 10/.05 and the afore-mentioned HyFlex EDM OneFile 25/~ (Figs. 4 , 13, 14). The fl exible fi les can even fi nd their way around tricky anatomies and are virtually unbreakable. They move perfectly in the centre of the canal, therefore I have never come across any perforations or ledges during my numer- ous treatments so far. After using “CM”-treated NiTi fi les, they can be quickly regenerated by autoclaving and are ready for their next application until they reach the end of their life cycle by displaying an uneven, bent shape. As long as they are not unwound they can be re-used safely, otherwise they have to be discarded. root canal preparation with NiTi fi les case report | Fig. 14: HyFlex EDM 10/.05. Fig. 15: Postoperative radiograph case 3 showing a severe double curvature in the mesial root. Fig. 15 nal with its striking double curvature at the end (Fig. 15). We are very glad that even in more chal- lenging cases like the present one we can rely on the versatility of the latest generation of rotary in- struments. Conclusion The latest generation of nickel titanium fi les adapt easily to all shapes of root canals thanks to their fl exible design and unusual cutting power. Whatever way you choose to reach the apex, pre- bendable NiTi fi les like the HyFlex EDM help you to fol- low the natural path of the root canal and quickly re- move debris for chemical cleansing and long-term obturation of the various root canal structures. The extremely fracture resistant fi les are literally “cutting edge” technology, which make an excellent travel companion on virtually every road._ contact Dr Alfredo Iandolo was awarded Doctor of Dental Medicine by the University of Naples Federico II in 2006. As Professor A.C. he has con- tinued speaking on endodontic courses at his home university since 2014. Iandolo is a certifi ed member of the ESE (European Society of Endodontics) as well as an active member of the SIE (Italian Society of Endodontics) and AIOM (Italian Academy of Microdentistry). As winner of the “Riitano Award” 2016 for best research in Endodontics Iandolo is a regular speaker at national and international congresses. The inventor of the Iandolo Gauging File (IG-File) and a new protocol in irrigation activation is widely published both nationally and internationally. After drying and successfully obturating the canal, we were able to dismiss the patient with a very prom- ising prognosis. The immediate postoperative radio- graph showed the naturally formed, fi lled mesial ca- Dr Alfredo Iandolo Via A. Ammaturo 126 B I-83100 Avellino, Italy iandoloalfredo@libero.it roots 2 2017 21