Question

During root canal instrumentation, the apical constriction is violated and enlarged to a size #50 instrument. Which of the following is appropriate treatment for this canal?

A. Obturate with gutta-percha and surgically remove extruded excess.
B. Fit a #50 gutta-percha cone with sealer and carefully condense.
C. Fit a #50 gutta-percha cone with sealer, but do not condense so as to keep the gutta-percha from being pushed into the foramen.
D. Reinstrument 1 mm. short of the foramen to a size #60 or larger and obturate using an appropriately sized master cone.

Answer 1

The appropriate treatment for an over-enlarged apical constriction to a size #50 during root canal therapy is to fit and carefully condense a #50 gutta-percha cone with sealer.

Step-by-step explanation:

In the case where the apical constriction is violated and enlarged to a size #50 instrument, the most appropriate treatment for this canal would be option B. This treatment involves fitting a #50 gutta-percha cone with sealer and carefully condensing the material within the canal. It is important to condense gutta-percha to ensure a proper seal and prevent micro-leakage; however, the dentist must perform this carefully to avoid pushing the gutta-percha past the apical foramen which could lead to post-operative pain or infection.

Option A is generally not ideal because surgically removing extruded excess gutta-percha is invasive and might not always be necessary. Option C is not recommended as gutta-percha should be condensed for a better seal. Option D is not advised because it indicates further enlargement of the canal which is already too large, risking weakening the root structure unnecessarily.