Newer NiTi rotary and reciprocating instruments have enabled the management of unusual and challenging root canal anatomies. While the use of these instruments has somewhat negated the plethora of problems encountered with hand instruments only, problems may still occur with the newer engine-driven instruments. This case report discusses the potential problem areas, highlights the integrated application of both hand and rotary instruments and details the benefits of this approach to achieve successful root canal procedures. Schlagwörter: dilacerated root canal, integrated root canal procedure, problem solving, S-shaped root canal