| case report
Driving on autopilot Dr Richard J. Gray, USA
“pit stop” should be made for rinsing. In the following report, the author describes his first test drive with a brand new endodontic motor and his experience “on the road”.
The long and winding road
1 Fig. 1: Pre-op radiographic image of tooth #47.
Introduction Long, narrow root canals are a real challenge even for renowned endodontic experts. Just like a good navigation system in your car, modern endodontic motors help you keep track on the long and winding road to the apex. In the following case, the clever co-pilot navigated the author safely through the treatment of a necrosis in tooth #47— indicating “traffic jams” as well as recommended “stops”. Mobility researchers and development departments of car manufacturers all share the dream of autonomous driving. When navigating through S-shaped canals by sight or following the tactile feedback, endodontic experts sometimes wish for the luxury of a fully automatic co-pilot too, a co-pilot who knows when it would be recommendable to change files and when a
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Fig. 2: Fully automatic endodontic motor. (© Coltène/Whaledent)
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roots 1 2021
This spring, a 33-year-old patient was referred to our practice complaining of pain in the right lower jaw. Radiographic diagnostics revealed, among other things, that the root canals were longer than usual. The mesial canals were 23 mm long, and the distal canal 22 mm. In addition, the canals were clearly narrowed in the apical third. Successful navigation through the root canal system would therefore become particularly difficult. Tooth #47 also showed a conspicuous brightening in the radiographic image (Fig. 1). The diagnosis was necrosis with asymptomatic periapical periodontitis. The patient agreed to the necessary root canal therapy. Owing to the given anatomical conditions, we chose the CanalPro Jeni endodontic motor to support the treatment. Jeni is a new type of digital endodontic assistance system developed by the international dental specialist COLTENE (Fig. 2). Jeni is named after its inventor, Prof. Eugenio Pedullà. While preparing an S-shaped canal, the Italian endodontic specialist came up with the idea of applying the concept of autonomous driving to the endodontic field for a safe and less error-prone root canal therapy. The result is a fully automatic endodontic motor that finds its own way through the canal. Being so proud of his groundbreaking invention, Pedullà wished the device to be named after him: Jeni.
Bumpy road ahead Like an experienced driver assistance system in a car, Jeni navigates the user safely and quickly through the canal. Thanks to complex algorithms, the endodontic motor controls the variable file movements every millisecond. The rotational movement, speed and torque are continuously adjusted to the conditions in the canal. In the following case, the main objective was to perform a safe and reliable procedure despite the demanding anatomy. This required a motor that minimises file stress and optimally manages torque forces by correcting the file movement. The motor should also react in time to obstacles or a restricted working field. Especially in long, narrow canals, it helps to have a “lane assistant” that knows when a file change is recommended.