PMC6854219_01
(a) Preoperative orthoradial X-ray; (b) preoperative distal angulated X-ray.
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They showed the presence of one wide canal and the presence of a deep mesial groove (Figure 1).
(a) Root canal system at the end of shaping procedure. (b, c) Root canal system during final rinse. (d) Canal drying using five sterile paper points.
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After the shaping procedure (Figure 2(a)), in order to assure proper three-dimensional cleaning of the root canal system, the final rinse solutions were activated using EndoUltra (Micro-Mega, Besancon, France): at first, an aqueous solution of EDTA 17% was activated inside the canal for 120 seconds. After rinsing with physiological saline, an aqueous solution of NaOCl 6% was activated inside the canal for 240 seconds (Figures 2(b) and 2(c)). The canal was dried three times using five sterile paper points, arranged in accordance with its palatal-buccal axis (Figure 2(d)).
(a) Visualization of the apical plug. (b) Backfilling of the root canal system using thermoplastic gutta-percha. (c) Postoperative orthoradial X-ray. (d) Postoperative angulated X-ray.
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fig3
In order to perform a tridimensional filling, the tooth was filled using a bioceramic material, MTA Biorep (Itena, Paris, France), creating an apical plug of 4 mm thickness (Figure 3(a)). The remaining part of the root canal was filled with thermoplastic gutta-percha, using EQ-V fill (Meta Biomed, Chungcheongbuk-do, Republic of Korea) in association with a canal sealer (Figure 3(b)). The final radiographs showed a well-obturated canal of this single-rooted maxillary first molar, with a large buccopalatal diameter (Figures 3(c) and 3(d)).
(a) Preoperative orthoradial X-ray; (b) preoperative distal angulated X-ray.
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The radiographs showed the presence of a deep pulp chamber floor with an unusual anatomy; two canals were clearly detectable (Figure 4).
(a) Visualization of the oval orifice of the MB canal (arrow). (b) Distal circular orifice and ribbon palatal orifice separated by a deep isthmus (arrow). (c) Isthmus shaped using sonofile.
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P canal and D canal were separated by a deep isthmus (Figure 5).
(a) Intraoperative orthoradial X-ray using verifiers. (b) Postoperative angulated X-ray. (c) Intraoperative photo with verifier. (d) Intraoperative photos after Thermafil filling.
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