case_images: PMC10893908_01
case_images: Periapical radiographs taken during root canal procedures for tooth #46. (A) The pre-operative radiograph of tooth #46 reveals previous treatment and significant structural reduction, along with a "J" shaped periapical lesion around the mesial root (indicated by a red arrow). There is radiopaque material in the mesial canals. Additionally, the tooth features an extra distolingual root known as radix entomolaris (yellow arrow).. (B,C) Periapical radiographs captured from two different angles to ascertain the working length.. (D) A periapical radiograph during the fitting of the master gutta-percha cones.. (E,F) Post-obturation periapical radiographs, each taken from a different angle.
case_images: cureus-0016-00000052931-i01.jpg
case_images: PMC10893908_01_cureus-0016-00000052931-i01.jpg
case_images: FIG1
case_images: A periapical radiograph showed extensive damage to the coronal tooth structure and pulp chamber floor (Figure 1A), a "J" shaped periapical lesion around the mesial root, and radiopaque material in the mesial canals. Tokyo, Japan), and periapical radiographs from different angles confirmed these lengths (Figures 1B, 1C, 2G). Acteon Group) removed the calcium hydroxide, followed by trial fitting of the main gutta-percha cones (Figures 1D, 2H). After drying the canals with paper points, the iRoot SP bioceramic sealer (Innovative Bioceramix, Vancouver, Canada) was injected into the upper portion of the canals. Two periapical radiographs from different angles evaluated the root canal filling quality (Figures 1E, 1F), and the access cavity was again temporarily sealed.
case_images: Photographs of root canal procedures for tooth #46 taken under a dental operating microscope. (A) The pre-operative photograph reveals extensive damage to the pulp chamber floor from previous treatment. The orifices of the mesial buccal canal (MB, indicated by a red arrow) and the distal lingual canal (DL, indicated by a yellow arrow) are visible.. (B) A dark line (marked by a blue arrow) suggests a potential developmental groove linking the MB canal orifice.. (C) The photograph displays the developmental groove connecting the MB canal orifice (red arrow) to the mesial lingual canal orifice (ML, green arrow). Near the ML canal orifice, a white spot (blue arrow) filled with dentin debris is evident.. (D) The photograph illustrates the developmental groove linking the MB canal orifice (red arrow), the distal buccal canal orifice (DB, green arrow), and the mesial middle canal orifice (MM, blue arrow).. (E) The DL canal orifice (yellow arrow) and the potential location of the distal buccal canal orifice (DB, purple arrow) are shown.. (F) The photograph displays the MB canal orifice (red arrow), ML canal orifice (green arrow), MM canal orifice (blue arrow), DB canal orifice (purple arrow), and DL canal orifice (yellow arrow).. (G) The photograph demonstrates the use of C-Pilot files for canal negotiation and working length determination.. (H) The photograph shows #30/.04 gutta-percha cones being used for master cone fitting.. (I) A post-obturation photograph reveals that the MB canal (red arrow), ML canal (green arrow), MM canal (blue arrow), DB canal (purple arrow), and DL canal (yellow arrow) have been filled with gutta-percha and bioceramic sealer.
case_images: cureus-0016-00000052931-i02.jpg
case_images: PMC10893908_01_cureus-0016-00000052931-i02.jpg
case_images: FIG2
case_images: The orifices of the MB and distal lingual (DL) canals were visible under the DOM (Figure 2A). A dark line suggested a developmental groove connecting the MB and ML canal orifices (Figure 2B). Acteon Group, Merignac, France) was used to trace the dark line, uncovering the ML canal orifice after further dentin removal with a stainless steel ultrasonic tip (ET21; Satelec Acteon Group) (Figure 2C) . A white spot near the ML canal orifice, filled with dentin debris, indicated the potential presence of an MM canal orifice. This was exposed using the ET21 ultrasonic tip (Figure 2D). Following the "laws of symmetry 2," the ET18D and ET21 tips were employed to locate the DB canal orifice (Figure 2E), which was successfully identified . All five canals of tooth #46 were located with the aid of the DOM and ultrasonic instruments (Figure 2F). Tokyo, Japan), and periapical radiographs from different angles confirmed these lengths (Figures 1B, 1C, 2G). Acteon Group) removed the calcium hydroxide, followed by trial fitting of the main gutta-percha cones (Figures 1D, 2H). After drying the canals with paper points, the iRoot SP bioceramic sealer (Innovative Bioceramix, Vancouver, Canada) was injected into the upper portion of the canals. The gutta-percha cones were cut at canal orifice level using a heat carrier tip (SybronEndo), and a Buchanan hand plugger (SybronEndo) compacted the heated gutta-percha (Figure 2I).