C-shape channels: what are they, seating arrangements, treatment features

Endodontics - a section of dentistry that studies the structure and function of tissues dentin and pulp, periodontium and root canals, as well as methods of their diagnosis and treatment. Particular attention is paid to the C-shape channels, which sometimes complicate the treatment process.

What is it, description

C-shape channels are formed in the mouth and the entire root system in the form of a C-shaped slit shape, which is often located in the lower jaw, in the second molars.

This arrangement requires a special approach during diagnosis, disinfection and treatment.

In some cases, the C-shape channel can be detected:

• in the first premolars;
• mandibular first molars;
• third molars;
• upper first molars;
• second molars of the upper jaw.

As a rule, the C-shaped canal is located apically to the level of the junction of the enamel-dentin border in the form of a single-tape opening at 180 °, reminiscent of the letter "C", hence its name. It was first described in 1979.

The main cause of the C-shape canals is the accretion of roots from the cheek by mesial, medial or distal contacts and between the inside of the teeth and the tongue (lingual) due to the destruction of the epithelial Hertwig vagina.

Seating

There are several classifications for C-shape channel seating, which were given in 1991. and 2004 With the study of this issue, new forms and types gradually appear.

According to Melton, 3 types are distinguished:

• solid, continuous channel in the form of the letter "C";
• c-shape channels are formed in the form of one point and two spliced ​​into one, similar to a comma;
• in the form of three separate points.

By Fan:

• continuous canal from the mouth to the dental canal, connecting to the hard surface of the tooth;
• in the form of two channels with a difference of 60 degrees, resembling a semicolon;
• two or three c-shape channels are located one by one with a difference of 60 degrees;
• the gap is formed in the form of an oval or circle;
• the channel is not visible, only closer to the apex.

There are also classifications by the angle of deviation (2004. S.S. Schneider), processing complexity (1990 g. Yu.A. Vinnichenko) and the complexity of treatment (1976. J.I. Ingle).

Diagnostics

C-shape channels represent a great challenge for the dentist in diagnosis, treatment and therapy. This unique anatomical feature is not easily recognized by traditional radiographic study with a two-dimensional camera.

Therefore, the c-shape channel is generally recognized when opening the dentin and encountering an unfamiliar pulp chamber shape. For a more reliable study and detection of bends, it is necessary to conduct a SAF survey on three-dimensional apparatus, which will allow you to fully identify the anomaly and correctly draw up a therapeutic plan.

To identify the correct location of the C-shape canal, a study of the pulp chamber is carried out, which will show what type of seating is used, after which therapy is carried out.

Treatment

If an unusual canal structure is found in the teeth, the patient is given endodontic treatment according to an individual scheme.

Before starting it, it is necessary to find out how curved the canals are, what methods and instruments can be used for disinfection and therapeutic measures.

C-shape channel is hard to handle antiseptic means. Cleaning can be complicated by the presence of a flat channel with a wide rib. Also, there may be mesh joints between the ribs, which also add problems during treatment.

After determining the number and length of the c-shape channel and their curvature, the following therapy methods are selected:

• with tools at bending angles up to 25 degrees;
• 25-50 degrees are difficult to pass for instruments, when it becomes necessary to expand the channel or use modern devices;
• bending more than 50 degrees does not allow instrumental treatment.

Treatment is carried out in several stages:

1. Canal treatment with disinfectants with 5.25% sodium hypochlorite.
2. Ultrasonic medical treatment.
3. Irrigation and disinfection of the lubricated layer with 15-17% EDTA, Solutio Citric Acid 10% can be added to enhance the effect.
4. After that, thorough drying is carried out using paper points and 96% alcohol.

For treatment against microorganisms in the treatment periodontitis use 2% Chlorhexidine. After treatment, the mesial and distal canals are closed to the level of root bifurcation, and the area above the root separation is filled with special cement or thermoplastic gutta-percha (resin identical to rubber). To soften the mass, they are treated with a heated tool.

The C-shape channel in most cases causes problems with diagnosis, processing and treatment due to its anatomical features. After such treatment, it is necessary to carry out a repeated 3-D examination after a few months.