case_images: PMC10566005_01
case_images: Periapical radiographs of the affected left mandibular first molar illustrating the treatment process and long-term outcome; A) Initial periapical radiograph showing a poorly obturated root canal without a proper coronal seal, an unusual amputation of the mesial root, and related endodontic lesion; B) Radiograph post-treatment demonstrating the placement of the apical plug using calcium-enriched mixture (CEM) cement in mesial root and intra-orifice barriers in distal root, with the access cavity sealed using a sandwich technique; C) The radiograph displaying the restoration of the tooth with the crown cemented in place; D) Follow-up periapical radiograph taken nine years later, revealing complete healing of the endodontic lesion
case_images: IEJ-18-271-g001.jpg
case_images: PMC10566005_01_IEJ-18-271-g001.jpg
case_images: F1
case_images: The initial periapical radiograph revealed a poor root canal obturation in mesial canals (but reasonable in the distal root canal), without a proper coronal seal in both roots (Figure 1A). Then the access cavity was filled and sealed using a sandwich technique using glass ionomer cement and resin composite (Figure 1B), and the crown was cemented again carefully (Figure 1C). These procedures effectively sealed the root canal system, and thus expected to prevent the reentrance of oral microorganisms as well as to promote periradicular healing.  At this extended follow-up, clinical examination showed that the tooth was asymptomatic/functional, and radiographic assessments revealed the remarkable outcome of complete healing of the previously existing endodontic lesion (Figure 1D).