When completing root canal therapy it is important to clean the canals to their apical terminations. Severe apical curvatures can make this challenging. It is often difficult to follow the natural path of the curved canal without causing iatrogenic damage. If the canal path can be maintain, file separation is a significant risk. In this case, I was able to create a reproducible glide path with hand files prior to using rotary files in an alternating crown-down technique. ProTaper Next X2 files were taken to length in all four canals (even the U-turn in the MB), with a brand new file being used in each canal to minimize fracture risk resulting from accumulated cyclic fatigue. A stainless steel post was placed with the bonded composite buildup, and I was able to prepare the subgingival distal crown margin under the microscope for the referring dentist.
