Ultrasound tips in endodontics

Use of a medium-power ultrasound tip to remove tertiary dentin accumulated in the pulp chamber of a lower molar.

Case carried out by students Andressa Camargo and Igor Fajan, from the endodontics specialization course at APCD Bragança Pta.

In: Figueiredo et al. Magnification and ultrasound as auxiliary resources in endodontic treatment in teeth with calcification: clinical considerations and case report. Arch Health Invest (2021) 10(1):174-178

INTRODUCTION
The goals of endodontic treatment (ET) consist of cleaning, shaping and filling through three-dimensional obturation of the root canal system (RCCs), and the long-term success of the ET is closely associated with such aspects.
However, in order to obtain success, operative steps such as the adequate performance of the access surgery and consequently the location and identification of the root canal opening are important requirements.
A difficulty that may be present during the ET consists in the obstruction of the root canal entry orifice, which may occur due to the presence of calcified structures in the form of secondary dentin deposits or pulpal calcifications (PCs) themselves.
The presence of calcified structures in the dental pulp are quite common alterations, and may affect deciduous or permanent teeth.
While calcified structures resulting from secondary dentin deposition may occur due to
response to the presence of restorative material inserted near the pulp, other PCs may occur freely in the pulp or be attached to the dentinal walls, taking the form of diffuse calcifications or pulpal nodules (PNs)3,5. Consequently, both the pulp chamber and the PPCs3 may obstruct the entry orifices of the canals, making it difficult to locate and access the SCRs.
Cone-Beam Computed Tomography (CBCT) has become an indispensable tool in clinical endodontic practice during diagnosis and TE planning, standing out as an important auxiliary method in the evaluation of SCR anatomy, as well as in the diagnosis of PPCs and the location of calcified canals.
Moreover, the use of auxiliary resources such as the operating microscope (O.M.) promotes a magnification with better lighting and visualization of the operative field, facilitating the localization of calcified root canals and allowing the execution of the Root Treatment. In addition, the use of ultrasonic devices can also assist in locating calcified and/or difficult-to-access root canals, these two clinical strategies being viable for accessing difficult-to-access areas due to the presence of CPs.

Obliterated canal and ultrasound.

https://ferrariendodontia.com.br/canal-calcificado/

https://www.youtube.com/results?search_query=carlos+ferrari+endodontia+ultrassom