O uso de ed file adaptador para instrumentação de canal lingual em pré-molar inferior com abcesso perirradicular agudo

Abstract

INTRODUCTION: Successful endodontic treatment requires accurate diagnosis and management of the complex morphology of the root canal. The main causes of failure in endodontic treatment are incorrect canal instrumentation, incomplete canal obturation, and untreated main canals. Endodontic therapy is performed with the aim of preventing or eliminating infection of the root canal system through cleaning and shaping processes, followed by obturation of this system and adequate sealing with definitive restorative materials. Mastery of the internal anatomy plays a very important role in the success of endodontic treatment. Normally, the first lower premolars have one canal, however, there are cases of variations in which they have two. Due to this complexity, complete sanitation and shaping is especially difficult. For successful treatment, we rely on the mechanical action of endodontic instruments, both manual and mechanized, and techniques are necessary to assist and facilitate the entire process of instrumentation and shaping of the canal. OBJECTIVE: To report a clinical case of endodontic treatment in a tooth with anatomical variation, using the ED File® adapter handle to direct the mechanized instrument into the canal, followed by coupling the endodontic motor to facilitate access and instrumentation of the root canal system. CASE REPORT: A lower right premolar with anatomical variation and local edema, diagnosed with acute periradicular abscess, was treated in two sessions. Computed tomography was requested due to the absence of canal light on the radiographic examination. Treatment was performed with NiTi rotary instruments inserted through the ED File® adapter and subsequently coupling the endodontic motor to the instrument already inserted in the canal. CONCLUSION: The technique applied proved to be effective in simplifying cases with anatomical variations, facilitating the insertion of the rotary instrument into the root canals with the use of the adapter handle. The ED file adapter reduced the risk of perforations, increasing the efficiency of decontamination and improving the treatment of acute periradicular abscesses. Although promising, the technique requires further clinical studies to evaluate its long term efficacy in different scenarios.