Tratamento de pré-molar superior com três canais, utilizando manobra de direcionamento do instrumento mecanizado com cabo adaptador seguigo de acoplamento do motor para instrumentação mecanizada

Abstract

INTRODUCTION: Endodontic therapy is carried out with the aim of preventing or eliminating infection of the root canal system from the cleaning and modeling processes, followed by the filling of this system and the appropriate sealing with definitive restorative materials. The mastery of internal anatomy plays a very important role in the success of endodontic treatment. Usually, the first upper premolars have two channels, but there are cases of variations in which they have three. Due to this complexity, a complete sanitization and modeling is especially difficult. For the success of the treatment, we rely on the mechanical action of the endodontic instruments, both the manual instruments and the mechanized instruments, for these techniques are necessary that help and facilitate the entire process of instrumentation and modeling of the channel. OBJECTIVES: To report a clinical case of endodontic treatment in a tooth with anatomical variation, with the use of the ED File® adapter cable directing the mechanized instrument to the interior of the conduit, followed by coupling of the endodontic motor that will aim to facilitate access and instrumentation to the root canal system. METHODOLOGY: Endodontic treatment will be performed in the upper premolar on the left side with anatomical variation, which presents a diagnosis of symptomatic irreversible pulpitis. Due to the blurring of the radiographic image, which suggests the presence of three root canals, Cone Beam Computed Tomography (CBCT) will be requested. The treatment will be carried out in 2 sessions, inserting the NiTi rotary instruments with ED File® adapter cable and subsequently coupling the endodontic motor to the instrument already inserted in the channel, in view of the ease of inserting a rotational instrument manually, in cases of complex anatomical variations. EXPECTED RESULTS: It is expected that it will be possible to insert the rotary instruments with ED File® adapter in all root canals, for subsequent coupling of the instruments in the endodontic motor, enabling cleaning and proper modeling. CONCLUSION: One of the difficulties of treating a tooth with anatomical variation is the insertion of the instrument inside the root canals, therefore, the adapter cable followed by the maneuver of coupling the motor in the instrument already inserted, will certainly offer greater dexterity and facilitate the process of insertion in the channels of difficult access, reducing the chances of an inefficient mechanical chemical preparation, and reducing the risks.