PMC5723965_01
Treatment sequence of tooth 45. (a) Preoperative radiograph. (b) Intraoperative radiograph with gutta-percha point. (c) Coronal view of intraoperative CBCT with gutta-percha point. (d) Postoperative radiograph.
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Radiographic examination revealed canal obliteration and a periapical radiolucency of the tooth (Figure 1(a)). Following that, a 0.5 mm in diameter GP point was placed and compacted at the depth of the preparation where the canal orifice was estimated to be (Figure 1(b)). The coronal view of the CBCT revealed that the canal orifice was located 1.46 mm buccally and coronally to the GP point (Figure 1(c)). Tulsa, OK, USA) using vertical compaction. The access cavity along with the space created lingually with ultrasonic preparing was sealed with composite resin, and a postoperative radiograph was taken (Figure 1(d)).
PMC5723965_02
Treatment sequence of tooth 46. (a) Preoperative radiograph. (b) Clinical picture of gutta-percha point at the estimated position of the orifice of the mesiobuccal canal. (c) Axial view of intraoperative CBCT with gutta-percha point. (d) Axial view of intraoperative CBCT 2 mm apically to the gutta-percha point. (e) Sagittal view of intraoperative CBCT with gutta-percha point. (f) Postoperative radiograph. (g) Radiograph at two-year follow-up.
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fig2
Mesial canals were obliterated and not visible (Figure 2(a)). A GP point was placed and compacted at the depth of the groove (Figure 2(b)). The axial view of the CBCT revealed that the canal was located 0.5 mm buccally to the GP point, and calcification was evident (Figure 2(c)). Furthermore, the canal seemed to be patent 2 mm apically to the GP point (Figure 2(d)). The sagittal view of the CBCT revealed that the orifice of the mesiobuccal canal was located 0.5 mm mesially to the GP point (Figure 2(e)). The access cavity was sealed with composite resin, and a postoperative radiograph was taken (Figure 2(f)). The patient was recalled yearly for clinical and radiographic follow-ups. At two-year follow-up, the tooth was asymptomatic, and periapical healing was observed radiographically (Figure 2(g)).
PMC5723965_03
Treatment sequence of tooth 18. (a) Preoperative radiograph. (b) Intraoperative radiograph with gutta-percha points. (c) Axial view of intraoperative CBCT with both gutta-percha points. (d) Axial view of intraoperative CBCT with mesiobuccal gutta-percha point. (e) Postoperative radiograph.
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fig3
Radiographic examination revealed canal obliteration and no apparent periapical radiolucency of the tooth (Figure 3(a)). Following that, two GP points were placed and compacted where the orifices of the mesiobuccal and palatal canals were estimated to be (Figure 3(b)). The axial view of the CBCT revealed that the palatal canal orifice was located at the GP placed on the palatal position whereas the mesiobuccal canal was located buccally to where the respective GP point was placed (Figures 3(c) and 3(d)). The access cavity was temporarily sealed with cotton pellet and Cavit G, and a postoperative radiograph was taken (Figure 3(e)). The tooth was followed up for a month and remained asymptomatic.