Page 25 - The Beauty and Sorrow in Endodontics-Chapter 2

multiple craze line (Fig 24E), a dark redness showing through its lingual

surface which indicates inflammation within the pulp, and arestoration

overhang on the mesiolingual (ML) surface (Fig 24F).The access cavity was
completed without local anaesthetics with no reported discomfort (Fig 24G),

and the pulp was confirmed to be necrotic (Fig 24H). Following the cleaning
and shaping guidelines from Dr. Schilder, the canal was shaped to the

targeted taper and working length along with ultrasonic irrigation with

sodium hypochlorite. Once the master cone fit radiograph (Fig 24I) showed
adequate fit, the canals were dried with paperpoints to the working length as

an additional safeguard measure, and they were then obturated with gutta
percha using warm vertical compaction technique. A fiberpost and resin core

buildup was completed to ensure adequate coronal seal. The rubber dam was
removed, and post-op instructions given to both the patient and her guardian.

It was recommended that the patient return for re-evaluation of 42 and 31
#
#
pulp vitality in one week. A post-op radiograph was taken for 41 which
#
shows the obturated canal following the natural curvature of the root. The

S-shaped curve at the apical portion indicates appropriate use of the files at
smoothening the irregular canal walls while maintaining adequate dentin

wall thickness. The sealer puff at the apex with white-in-white dot further

signifies a densely filled apex (Fig 24J).

2) Follow-up
#
1-week– The patient reported no discomfort since 41 treatment completion.
#
The patient and guardian consented to 42 and 31 cavity tests.
#

#
#
3) 42, 31 Cavity Test
#
#
Rubber dam placed and cavity testing of 42 and 31 were completed
with no local anaesthetics and both elicited normal response (Fig 24K). The
teeth were restored with composite resin and the patient and guardian were
notified of the good news.

23