PMC3915394_01
Case I (a-d), Case II (e-h) and evaluation on extracted teeth (i-l). (a) Grossly violated unfilled palatal foramen of tooth #2. (b) PC projected externally. (c) PC obturated with mineral trioxide aggregate (MTA). (d) 3 months postoperative. (e) Incomplete fracture extending from the mesiolingual canal to the distal canal of tooth #19. (f) All three canals projected externally. (g) MTA obturated in all canals. (h) One-year follow-up indicates healing. (i) Voids frequently noted when all canals are packed at one time. (j) Longitudinal section to compare the ortho and retro fills. (k) LS to show the extent of coronal and apical dye leakage. (l) Homogeneity of the interface as observed after demineralization
JCD-17-80-g001.jpg
PMC3915394_02_JCD-17-80-g001.jpg
F1
A 40-year-old asthmatic and phobic male was referred from a local clinic to manage the incomplete fracture of tooth no. 19 that runs from the mesiolingual canal (MLC) to the distal canal (DC) in the furcal region [Figure 1e]. With due informed consent, Interlig fiber (Angelus, Brazil) was bonded across the fracture and the rest of the core was built using a para core after blocking all three canal orifices with GP stumps [Figure 1f]. Then, each canal was unitarily obturated with pro root MTA as described in the technique above [Figure 1g]. Abrupt shortening and porosities may be prone in both ways [Figure 1i]. Our preliminary examination reveals a dense homogenous pack with good marginal adaptation, minimal porosities and dye leakage [Figure 1j-l].
Schematic illustration of the canal projection method and orthograde mineral trioxide aggregate compaction technique. Note: The elected canal is depicted as transported, apically perforated and gouged near the orifice. See text for description of the technique
JCD-17-80-g002.jpg
PMC3915394_01_JCD-17-80-g002.jpg
F2
Tulsa Dental Specialties, Tulsa, TN, USA) was packed in the PC [Figure 1c] as per the general technique described below [Figure 2]. The postoperative period was uneventful and tenderness to percussion resolved in 2 weeks' time. Around 10 mm of the GP stump should be extruding out of the cavity to assist its removal later [Figure 2a]. Switzerland) following the manufacturer's instructions [Figure 1b and f]. Slowly rotate and pull out the GP stump to establish a unit canal with its orifice projected to the external surface occlusally [Figure 2b]. Enlarge the transported orifice using safe end burs or GG drill to enhance the funnel size and to gain straighter access [Figure 2c]. LS at 1000 rpm in a slow pumping motion to carry it down to the middle third [Figure 2d]. LS may be introduced till the apical third if the apex is closed. Now, insert P1 till the WL and give five to ten quick up and down strokes of 3-5 mm amplitude circumferentially [Figure 2e]. Soak out the excess moisture from the canal using an absorbent point corresponding to the MAF size [Figure 2f] and work the P1 in a similar manner again. Then, P2 takes the charge and a similar procedure is followed [Figure 2g]. The rest of the larger part of the canal is completed using P3 [Figure 2h] and the butt end of the larger paper points.
PMC3915394_02
Case I (a-d), Case II (e-h) and evaluation on extracted teeth (i-l). (a) Grossly violated unfilled palatal foramen of tooth #2. (b) PC projected externally. (c) PC obturated with mineral trioxide aggregate (MTA). (d) 3 months postoperative. (e) Incomplete fracture extending from the mesiolingual canal to the distal canal of tooth #19. (f) All three canals projected externally. (g) MTA obturated in all canals. (h) One-year follow-up indicates healing. (i) Voids frequently noted when all canals are packed at one time. (j) Longitudinal section to compare the ortho and retro fills. (k) LS to show the extent of coronal and apical dye leakage. (l) Homogeneity of the interface as observed after demineralization
JCD-17-80-g001.jpg
PMC3915394_02_JCD-17-80-g001.jpg
F1
A 40-year-old asthmatic and phobic male was referred from a local clinic to manage the incomplete fracture of tooth no. 19 that runs from the mesiolingual canal (MLC) to the distal canal (DC) in the furcal region [Figure 1e]. With due informed consent, Interlig fiber (Angelus, Brazil) was bonded across the fracture and the rest of the core was built using a para core after blocking all three canal orifices with GP stumps [Figure 1f]. Then, each canal was unitarily obturated with pro root MTA as described in the technique above [Figure 1g]. Abrupt shortening and porosities may be prone in both ways [Figure 1i]. Our preliminary examination reveals a dense homogenous pack with good marginal adaptation, minimal porosities and dye leakage [Figure 1j-l].