Single-File Preparation

"Shape most root canals using only one file and decrease total shaping time..." I am sorry, but in cases like this one, the total shaping time should be increased to allow an adequate disinfection of the isthmuses that were not even touched by the instrument. Otherwise, most of the canal surface area will be kept without any treatment. With these images, it is possible to understanding the real influence of the root canal anatomy on the endodontic procedures.

The root canal space is an arborizational, anastomotic, labyrinthine complexity, morphologically comparable to the pathways of a maze. While primary canals exist, the tributaries, accessory branches and lumina of the dentinal tubuli harbor extensive tissue and microflora. The existence of these vast, capacious passages has been demonstrated throughout the past century beginning with the work of Hess and continues to this day with the use of micro computed tomography. Presence of multiple foramina, additional canals, fins, deltas, intercanal connections, loops, C-shaped canals and accessory canals are an integral part of the pulpal anatomy. Morphology of the apical portion of the root varies tremendously, including numerous accessory canals formed as a result of entrapment of periodontal vessels in Hertwig’s epithelial root sheath during calcification, areas of resorption and its repair, attached, embedded and free pulp stones, varying amounts of irregular dentin, intercanal connection that may become exposed and single foramen may become multiple.Adding to these is the root curvature especially in the apical portion, which makes the endodontic treatment all the more complex. (Ken Serota) You can read the complete article here.

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CTVol software was used for three-dimensional visualization and qualitative evaluation of the preinstrumented and postinstrumented canals. Color-coded root canal models (green indicates preoperative, red postoperative canal surfaces) enabled qualitative comparison of the matched root canals before and after shaping.

Keywords: micro-computed tomography, micro-ct, marco versiani, micro-computer tomography, high resolution x-ray tomography, dental anatomy, root canal anatomy, single-file preparation, WaveOne, Reciproc.