Assalammualaikum Wr Wb.. Good Morning!!
welcome back to SekilasKonservasiGigi.Com, a full story of my mini series updated from my social media such as instagram, facebook, google plus, and also twitter. Sometimes, I also updated my cases at Line or Linkedin. 🙂 this topic will focus only on conservative dentistry cases such as restorative dentistry and endodontic or root canal treatment.
Endodontic treatment on lower right second molar with c-shaped canal, gingival hyperplastic, and chronic pulpitis hyperplastic.
This case was sent last week from my friend, also a dentist, Dr. Valeria Widita. This patient, we call it Juna, is 23 years old. Complaining about her persistent dental pain on lower molar. She had her gum bleed every time she brush her tooth
At first i saw a hyperplastic soft tissue inside tooth cavity and the gum. Tooth still vital. And the tissue origin was different between inside and outside the cavity.. after taking proper examination and informed consent, i started the dental treatment.
First, i cut the soft tissue inside and outside cavity. Waiting a while until the soft tissue stop bleeding. Then i put greatercurve matrix, and place glass ionomer cement (ketac molar – 3M) to rebuild the distal wall, prior to put rubber dam (hu friedy rubber dam clamp and blossom rubber dam sheet)
This part, i realized that i faced a c-shaped canal.
By The definition of the C-shaped root canal system is that the morphology of its horizontal cross section is in the form of a C, with canals which may or may not be separate.
MELTON (1991) proposed the following classification based on the different configurations of the orifices in C-shaped canal systems. • Class I: a continuous C-shaped canal, with no separation of the canals. • Class II: the canal orifices resemble a semicolon (;), where a C-shaped canal is present buccally or lingually, separated from another distinct canal by a dentine wall. • Class III: two or more separate canals are present, as in a typical lower molar, with three canal orifices.
In all three classes, the “main” canals can be cleaned and shaped normally; however the instrumentation of the isthmus that connects these canals requires care, because although it may be extensive, it may also be very narrow. Copious amounts of irrigants is a must in this case..
Root canal preparation with Mtwo (VDW) with clockwise reciprocal motion. Followed with copious amount of irrigation with NaOCl 5,24%, EDTA 18% Sol (ultradent), Chx 2% (consepsis – ultradent) prior to root canal obturation.
Radiographic evaluation with VistaRay 7.1 (Durr) showed a well filled canal, intact margin of dentine-guttapercha-composite resin, and homogeneous filling.
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Wassalammualaikum Wr Wb..
-drg. Rio Suryantoro, Sp.KG-