C LI N I C A L R E P O R T S

The anticurvature filing method to prepare the

curved root canal

M arw an Abou-Rass, D D S, PhD

Alfred L. Fran k , DDS
Dudley H. Glick, D DS

A m e t h o d o f p r e p a r a t io n o f th e
c u r v e d ro o t c a n a l is d e s c r ib e d b y
w h ich en d o d o n tic fillin g m a te r ia l
ca n b e in tr o d u c ed w ith little r is k
o f d a m a g e to th e c a n a l w alls.

TJL he transition to the use of gutta­

percha as the preferred endodontic
F ig 1 ■ S c h e m a tic d ra w in g o f a p ic a l stop and
filling material and the increased use d isp la ce m en t s p a c e p re p a re d fo r g u tta -p e rch a
of condensation methods (lateral and p o in ts, th ereb y a v o id in g a p ic a l o v erfill.
vertical) have resulted in definitive
changes in the design of the endodon­
tic canal preparation. Gutta-percha is the bulky or safety zones and away F ig 2 ■ S c h e m a tic d ra w in g o f ro o t c a n a l p rep a ­

biologically acceptable and more per­ from the thinner portions or danger ra tio n by a n tic u rv a tu re filin g sh o w s m od ified

zones of the root structure where per­ d ir e c t a c c e s s to a p e x , a v o id in g th in n e r d a n g er

manent, but it is difficult to manipu­
late. This paper introduces a clinical
method—anticurvature filing— for the
preparation of the curved or narrow
canal to receive gutta-percha filling
m aterials.1,2
D efin ition o f te rm s
— Apical stop. The apical lim it of the
root canal preparation located within 1
mm from the radiographic apex to con­
fine the filling material during the dis­
placement and filling process (Fig 1,
2).
— A nticurvature filing. The co n ­
trolled and directed preparation into
foration or stripping of the canal walls
can occur (Fig 3).
— Stripping. Thinning of the dentin
to the cementum border, which can
develop into a perforation (Fig 4).3
— Danger zone. The thin area in the
root canal wall that is vulnerable to
stripping by injudicious filing (Fig 3).
THE NEED FOR ANTICURVATURE FIL­
ING. The preparation of curved and
narrow root canals presents-a special
challenge to the dentist. Many pro­
cedural errors, such as ledge forma­
tion, loss of root length, perforation
and stripping of the canal walls, in-
z o nes, an d d e fin itiv e a p ic a l sto p an d d is p la ce ­
m en t s p a ce fo r c a r e o f fillin g w ith g u tta -p e rch a .
strument fracture, and overfills and
underfills, can occur during the prepa­
ration of root canal therapy. The pur­
pose of anticurvature filing is to file
the bulkier root structure away from
the curvature and thinner danger zone.
The anatomy of the root canal, cur­
vature direction, and canal diameter
should be carefully analyzed before
access and canal preparation. The
original internal m orphological de­
sign of the canal should be modified to
produce the proper canal design, con­

792 ■ JADA, Vol. 101, November 1980


densation space, and apical stop to
obliterate the canal and prevent per­
forations of the canal walls. In round
and nearly straight roots, in which the
canal is centered in the root, wall
thicknesses are approximately equal
in the buccolingual and mesiodistal
cross sections, and circum ferential
filling can be used. In curved canals,
anticurvature filing is necessary to
prevent perforation and weakening of
the root structure by stripping. Anti-
curvature filing is based on radio-
graphic and topographic analysis of
the root and root canal anatomy.4 The
curved canal should be straightened as
much as possible to ease the cleaning,
designing, and filling of the apical
third. In an extreme apical curvature,
the canal is straightened as close as
possible to the point of apical curva­
ture (Fig 5).
The wall thickness of curved canals
F ig 4 ■ C lin ic a l ex a m p le s o f s trip p in g an d p e rfo ra tio n s th a t co u ld h a v e been p rev en ted by a n tic u rv a tu re filin g .
can be irregular and variable.5 In the
b u c c o lin g u a l or m e s io d is ta l d i­
rections, circumferential filing could
be hazardous (Fig 3). The danger of
perforation is greater as preparation is
performed to larger sizes.6
A C C E S S P R E P A R A T IO N . A w e ll-
executed access preparation makes it
easier to locate all canal orifices and to
facilitate the preparation stage. To
prepare the apical stop with the anti­
curvature filing method (Fig 6), the ac­
cess outline and extension may have to
be modified. Clinically, the access out­
line may have to differ from the tradi­
tional geometric forms; an accurate ac­
cess outline should blend smoothly
into the pulp chamber. It should in­
clude the total removal of the pulp
chamber roof and all pulp horns and
provide, as much as possible, a direct
and unobstructed approach to each
A b o u - R a s s - F r a n k - G lic k : A N T IC U R V A T U R E F IL IN G F O R R O O T CAN AL ■ 7 9 3
C LIN IC A L REPO RTS
canal. The access preparation is never
static and should be altered as neces­
sary to provide convenience or root
canal preparation.
RADIOGRAPHIC AND FUNCTIO NAL
CONSIDERATIONS. The root anatomy
and morphology is all-important in the
planning and execution of root canal
preparation. The practitioner should
maintain digital and directional con­
trol over the endodontic instrument
when performing the following steps:
— The danger zone where the walls
are thin is located.
— To minimize torquing of the en­
dodontic instrument, a functional ac­
cess opening that allows for as much
direct and unobstructed access to the
apical stop level as possible is made.
—A radiograph of the region with a
size no. 15 file in place should be ex­
amined to determine the torque of the
C LIN IC A L REPO RTS
Fig 6 ■ Anti curvature filing directs preparation into bulky portions away from thinner zones of
root to avoid perforation or stripping of canal wall.
instrum ent generated by the canal.
This w ill disclose the degree of canal
curvature and indicate where the fil­
ing should be directed.
— The endodontic instruments are
curved to ease insertion and negotia­
tion of the canal.
— The curved canal is progressively
and directionally filed away from the
thin areas in the regions where bulky
tooth structure is present. If the curve
of a root is to the distal, the canal is
filed mesially, buccally, and lingually.
— Overzealous circumferential fil­
ing and restricted access openings
should be avoided, as they lead to per­
foration or stripping.
— Evaluation of radiographs and
frequent irrigation during the proce­
dure, and the use of sharp instruments
w ill ease the preparation.
794 ■ JADA, Vol. 101, November 1980
— The canal orifice may be enlarged
using a suitable rotary instrum ent
such as a no. 1 or a no. 2 Peeso reamer.
Rotary instruments should not be in­
serted into the canal more than 3 mm
from the floor of the pulp chamber
level. A manual instrument should fol­
low the use of rotary instruments to re­
capitulate and blend the canal walls.
Summary
The anticurvature filing method main­
tains the integrity of canal walls at
their thin portion and reduces the pos­
sibility of root perforation or stripping.
With this method, the dental practi­
tioner maintains digital control over
the endodontic instrument, and the
preparation of the curved canal is
eased.
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