Management of Calcified Root Canal: A Case Report

Abstract

Background: Calcification of root (calcific metamorphosis) is usually seen as defensive reaction of pulp to
trauma. Intensity of trauma/hit, time span since trauma, pulp response to trauma are multiple factor deciding
degree of calcification. Calcification may be seen partially or entirely in root canal. Usually calcified
tooth remain asymptomatic, but when tooth becomes symptomatic endodontic treatment need to be done.
Treatment of calcified canal is challenge to dentist.
Case report: A female patient reported to the department of conservative dentistry and endodontics at sharad
pawar dental college with chief complain of pain in upper front region of jaw. On radiographic examination
calcified root canal was associated with upper anterior teeth. Root canal treatment was planned for calcified
tooth. Access opening was carried out using BR45. To achieve patency within canal file#8, 10 were used, but
initally patency could not be achieved due to calcified canal. With help of chelating agents 17% EDTA liquid
and gel and small size K file #8,10 canal negotiation was carried out to achieve patency. Working lengh was
then determined and canal was instrumented. Naocl, EDTA was used as intermittent irrigant. Final rinse was
done using 2%CHX. Canal was obturated using cold lateral condensation technique followed by permanent
restoration. Entire procedure was carried out under magnification.
Conclusion: Calcified canal treatment is bit tedious then routine endodontic procedure. But it can be
managed if procedure is carried out under proper illumination, magnification, CBCT, understanding root
canal anatomy, use of dye, modified access bur, files, chelating agent, irrigants and irrigation activation
system.