Deviations from the Canal Anatomy

Deviations from the normal canal anatomy are usually in the form of ledges that can occur anywhere along the length of the canal (Fig. 10-10): zips, that usually occur at the apical extent of the canal (Fig. 10-11); false canals, which occur if a ledge is accentuated with aggressive instrument activity of the instrument tip against the wall until the instrument creates its own exit out of the root (some refer to as a root perforation) (Fig. 10-12); or strip perforations that occur with the lateral cutting of an instrument anywhere along the root wall (primarily in areas of root wall thinness or natural external root invaginations), resulting in a longitudinal laceration of the root structure (Figs. 10-13 and 10-14).* As with the loss of working length, these errors occur primarily with the use of stainless steel hand instruments (K-files). However, in any given root canal anatomy, these problems may also occur when using NiTi rotary instruments with lack of attention during instrument application. In this regard, deviations with NiTi instruments are prevented by (1) developing a smooth, clean pathway in the canal before placement of specific NiTi instruments used for enlarging and shaping, and (2) using the instruments only to their desired length for only a few seconds. Repeated placement of these instruments to length or holding them at length during

rotation will result in canal deviations and possible breakage, especially if excessive pressure is placed on the instrument by the clinician.