PMC4312998_01
Preoperative radiograph shows normal root canal anatomy and apical lesion (a); radiograph to determine working length (b); radiograph shows gutta-percha cones placed in canals (c); postobturation radiograph shows 6 root canals and independent apical foramina ((d) and (e)); clinical view of pulp chamber after root canal treatment (f); periapical repair 6 (g) and 18 months after treatment (h).
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Pretreatment radiographs of the tooth showed a normal root canal anatomy and an apical lesion (Figure 1(a)). Morita MFG Corp, Kyoto, Japan), with a size 10 K-type file, confirmed radiographically (Figure 1(b)). Obturation was performed using the continuous wave of condensation technique and gutta-percha points (Odous, Belo Horizonte, Brazil) and Grossman sealer (Endofill, Dentsply, Rio de Janeiro, Brazil) (Figures 1(c), 1(d), and 1(e)). The conventional triangular access was modified to a trapezoidal shape to improve access to the additional canals (Figure 1(f)). Clinical examination of the tooth was normal and the radiograph revealed decreased apical radiolucency (Figure 1(g)), despite the defective restoration present on coronal portion. Patient was referred for the placement of new crowns and during the 18-month follow-up, it can be noted that patient is under orthodontic treatment and complete healing of periapical lesion was achieved (Figure 1(h)).