Endodontic management of badly broken down tooth with radix entomolaris using the canal projection technique

Abstract

The management of teeth with minimal coronal structure can be a challenging task when root canal treatment is required as a part of oral rehabilitation. Coronal leakage, isolation complexities, and risk of interappointment coronal-radicular fracture may be major contributors to endodontic failure. It is a great challenge to an endodontist to maintain root canal patency while isolating grossly destructed tooth with open pulp chamber, without blocking the root canals with restorative material. Pre-endodontic build-up of the coronal tooth structure following caries removal and identification of all the canal orifices while maintaining the canal patency can facilitate the endodontic process by providing a strong core and coronal seal. Hence, a restoration before endodontic treatment is mandatory during management of these teeth. This can be achieved successfully by the canal projection technique, wherein a tapered plastic sleeve is used to maintain the canal patency, projecting the canal from pulp chamber to cavosurface margin. Taking into consideration the limited worldwide availability and cost of original projectors, the aim of the present case is to highlight a simple yet effective method of placement of a pre-endodontic restoration using the canal projection technique by custom made plastic sleeves. This case report demonstrates the use of an innovative technique for canal projection, as an efficient method for managing complex cases.