Glide path and root canal preparation in reciprocating motion: root canal treatment of a mandibular premolar with complex root canal morphology using R-Pilot and Reciproc Blue

Introduction: The mechanical preparation of a root canal system is indispensable for a successful endodontic treatment outcome. Teeth with complex root canal morphologies, in particular, represent a special challenge; the practitioner should possess thorough knowledge of root canal morphology, as well as, be able to employ suitable endodontic instruments. The development of new nickel titanium alloys, through modifications made to their material properties, now permits the production of endodontic instruments which can meet even the highest requirements for root canal preparation. In this manner, the incidence of preparation errors and instrument fractures can be considerably decreased. Materials and Methods: A female patient with acute dental pain, originating from tooth 34, presented herself to the Department of Periodontology and Conservative Dentistry, a part of the University Clinic Münster. Following a detailed examination, root canal treatment on the tooth was performed. In this case report, R-Pilot and Reciproc Blue instruments (both VDW, Munich, Germany) were employed to treat a first mandibular premolar with a Vertucci type III canal configuration. Results: In the present case, in spite of complex root canal morphology, a sufficient and satisfactory root canal treatment outcome was achieved. This was realized through the use of R-Pilot files to establish an initial glide path and the subsequent use of Reciproc Blue files for further canal preparation. Conclusion: Knowledge of possible root canal system configurations and identification of such cases in daily clinical practice is a prerequisite for successful root canal therapy. Furthermore, a case-specific selection of endodontic instruments should be performed in order to prevent preparation errors and instrument fractures. It is also important to point out that a preceding glide path preparation helps to facilitate an easier and safer canal preparation and should therefore be considered as obligatory. Keywords: Blue-Wire, M-Wire, R-Pilot, Reciproc-Blue, glide path