How PA FILES Revolutionized Treatment of a Complex Curved Root Canal: Dr. Ana Planinic's Case Study
Introduction:
The Challenge of Curved Root Canals
Endodontic treatment of teeth with severely curved root canals presents significant clinical challenges. Dr. Ana Planinic, a renowned endodontist from Bosnia and Herzegovina, recently demonstrated how PA files can successfully overcome these difficulties in a challenging case of irreversible pulpitis. This case highlights the crucial role of Denco's PA files in managing complex root canal anatomy.
Case Presentation: Severe Pain from Tooth 38
The patient presented with severe, sleep-disrupting pain in the lower right quadrant. After comprehensive examination, Dr. Planinic diagnosed symptomatic irreversible pulpitis of tooth 38. The treatment plan involved two visits:
First Visit Protocol:
- Administration of local anesthesia
- Complete removal of carious dentin
- Pre-endodontic buildup for rubber dam isolation
- Vital pulp extirpation
- Placement of temporary restoration
The PA Files Breakthrough
During the second visit, Dr. Planinic encountered extremely curved root canals that resisted conventional preparation:
"Manual K-files failed to establish a proper glide path due to the severe curvature," Dr. Planinic explained. "This is where Denco's PA files made all the difference - they allowed me to successfully negotiate the canals and reach the apex."
Key Technical Details:
- Used PA files in an endomotor with reciprocating motion (90/60 angle setting)
- Maintained continuous irrigation with 3% NaOCl to prevent dentin chip blockage
- Followed with ProFlexi files (Denco) up to size 25/04 for final shaping
- Performed final irrigation with 40% citric acid and 3% NaOCl, activated with Denco's endoactivator
- Completed obturation using the monocone technique
Why PA Files Made the Difference
Dr. Planinic emphasized that PA files were instrumental in this successful outcome:
- Superior flexibility to navigate severe curvatures
- Efficient debris removal while maintaining canal patency
- Compatibility with reciprocating motion for safer preparation
- Reduced risk of transportation or perforation
Conclusion:
A Valuable Tool for Complex Cases
This case demonstrates how PA files can solve challenging endodontic situations where traditional instruments fail. Dr. Planinic's experience confirms that having PA files in the endodontic armamentarium significantly improves success rates in curved canal cases.
For clinicians facing similar challenges, Dr. Planinic recommends:
- Having PA files available for complex anatomy cases
- Using appropriate irrigation protocols
- Adjusting motor settings (90/60 reciprocation) for optimal performance
PA files continue to prove their value in modern endodontics, particularly in cases of severe canal curvature where conventional instruments may fall short.
