[Root Canal Treatment] What You Should Know When Treating the Lower Molar (C-shaped Canal, High-Difficulty Treatment)

Hello.

I am Jeon Jun-hee,

a specialist in conservative dentistry

and the director of Shinchon Chiagijimhee.

Today, I will introduce an unwelcome guest that is often encountered

when treating the very last lower molar.

It is the C-shaped canal.

Inside a tooth, the nerve is located.

In most molars, the nerve extends straight from the crown to the root.

But in the case of a C-shaped canal,

the nerves are attached together like a curtain,

which makes access difficult,

and even when access is possible,

complete removal is difficult.

While looking at the most representative paper

on the anatomical structure of C-shaped canals,

I would like to explain.

It was excerpted from the International Endodontic Journal,

a reputable journal in the field of root canal treatment.

It is based in Europe,

and the journal based in the United States is the Journal of Endodontics.

Both are excellent journals, and I have also studied by reading papers from both.

https://doi.org/10.1111/iej.12256

The most distinctive feature of a C-shaped canal is

that the roots are gathered in a cone shape.

Instead of stretching out both legs,

you can think of it as the legs being politely brought together, or as a cross-legged shape.

Because the nerve exists inside the tooth’s legs (= roots),

the nerves within a C-shaped canal with gathered roots are irregularly fused with one another.

The difficulty of root canal treatment increases greatly.

https://doi.org/10.1111/iej.12256

When the tooth root is cut in cross-section, a C-shaped nerve can be observed inside the tooth, as in (a).

https://doi.org/10.1111/iej.12256

(a) shows the usual molar nerve system, and (b) to (d) show the anatomical structures of various C-shaped canals.

There is no real rule to it.

There are many exceptions, and I think there are quite a few areas that cannot be touched at all during treatment.

https://doi.org/10.1111/iej.12256

Unfortunately..

The place where C-shaped canals are most common is Northeast Asia.

Especially Korea.

Since it is found in more than 30%, it appears in about one out of three people.

There seems to be a reason why Korean specialists in conservative dentistry are so excellent^^;

I will introduce some C-shaped canals I have recently encountered.

An example of C-shaped canal treatment at our clinic - woman in her 20s

An example of C-shaped canal treatment at our clinic - woman in her 30s

An example of C-shaped canal treatment at our clinic - man in his 20s

An example of C-shaped canal treatment at our clinic - woman in her 20s

An example of C-shaped canal treatment at our clinic - man in his 20s

None of them have the same shape.

Of course, there are standard categories for C-shaped canals.

However, we always try not to be complacent and to treat them carefully.

With the help of a microscope, which brightens my vision,

and an ultrasonic device that cleans areas my hands cannot reach,

I strive to provide the best care possible.

This is me performing treatment under a microscope^^

Using ultrasound, I can thoroughly clean every corner of the tooth

that straight instruments cannot reach.

It is important to clean out the inside of the tooth completely.

Wishing everyone a smooth root canal treatment,

I will end this post here^^

Treatment of natural teeth is done well by specialists in conservative dentistry.

If you visit the website of the Korean Academy of Conservative Dentistry,

you can find a nearby specialist in conservative dentistry.

#ConservativeDentistrySpecialist #ShinchonChiagijimheeDirectorJeonJunhee