PMC4241281_01
(a) Preoperative. (b) and (c) Working length determination. (d) MTA apical plug of 4-5 mm thickness. (e) Final obturation. (f) After 8-month reassessment, continuous lamina dura and consistent width of periodontal ligament space suggest healing of the periapical lesion.
CRID2014-673127.001.jpg
PMC4241281_01_CRID2014-673127.001.jpg
fig1
Radiographic examination revealed deep pit communicating with pulp and presence of blunderbuss canals (Figure 1(a)). Apex locator produced inconsistent canal length reading so a check radiograph was used to confirm the actual working length (Figures 1(b) and 1(c)). Repeated radiographs were obtained to check adequacy of MTA (Figure 1(d)). The canals were dried using sterile paper points and obturated using ZOE sealer and injectable thermoplasticized gutta-percha (Figure 1(e)).
PMC4241281_02
(a) Preoperative. (b) Working length determination. (c) MTA apical plug of 4-5 mm thickness. (d) Final obturation. (e) After 8-month reassessment, continuous lamina dura and consistent width of periodontal ligament space suggest healing of the periapical lesion.
CRID2014-673127.002.jpg
PMC4241281_02_CRID2014-673127.002.jpg
fig2
Radiographic examination revealed deep pit extended to involve pulp with periapical radiolucency and presence of open apex on distal root of the lower right 1st molar (Figure 2(a)). Tooth isolation, access preparation, extirpation of pulpal remnants, and working length determination were followed the same as case 1 (Figure 2(b)). Application of intercanal medicament and access obtained in case 1 and apexification using MTA were done for only distal root canal (Figure 2(c)). Finally obturation of all 3 canals was done using ZOE sealer and injectable thermoplasticized gutta-percha and final radiograph was obtained (Figure 2(d)).