The challenge of preparing the curved root canal

Heavily restored teeth which become pulpally involved are now often root canal treated rather than extracted. While this is laudable it has a significant impact on the practice of endodontics today. The curved calcified canal can prove very difficult to prepare to its natural shape by conventional techniques and there is always the likelihood of iatrogenic damage. To compensate for this many clinicians tend to under-prepare these canals, perhaps leaving them inadequately cleaned and certainly remarkably difficult to fill to length. The purpose of this article is to outline the stages of and the rationale behind a hand instrumentation preparation method which uses the balanced force method of movement of files from canal entrance to apical constriction. In the authors' experience this technique has gone a long way towards solving the problem of cleaning and shaping the fine curved canal. With some practice, but no extra expense, the technique described will not only speed up canal preparation but will also make it more predictable.