case_images: PMC11217572_01
case_images: Pretreatment. (a) Panoramic and (b) periapical radiographs.
case_images: CRID2024-9962576.001.jpg
case_images: PMC11217572_01_CRID2024-9962576.001.jpg
case_images: fig1
case_images: A periapical and panoramic radiograph indicated an intact lamina dura, a uniform periodontal ligament space, and an abnormal length in the suspected tooth (#13) (Figure 1).
case_images: Periapical radiograph indicating a working length of 40 mm and the need for an additional 9 mm to achieve full working length.
case_images: CRID2024-9962576.002.jpg
case_images: PMC11217572_01_CRID2024-9962576.002.jpg
case_images: fig2
case_images: A periapical radiograph was taken to evaluate the necessary modifications, confirming a working length of 40 mm and indicating a need for an additional 9 mm (Figure 2).
case_images: Modified handle of the endodontic hand file, prepared with diamond burs. (a) Endodontic hand file measured with a digital caliper. (b) File inserted into the tooth at its full working length.
case_images: CRID2024-9962576.003.jpg
case_images: PMC11217572_01_CRID2024-9962576.003.jpg
case_images: fig3
case_images: To achieve the desired length, the handle of the endodontic hand file was carefully modified using diamond burs (Figure 3).
case_images: The 50 mm side-vented 27-gauge microcannula used for irrigation.
case_images: CRID2024-9962576.004.jpg
case_images: PMC11217572_01_CRID2024-9962576.004.jpg
case_images: fig4
case_images: A 50 mm side-vented 27-gauge microcannula (Time Machine Co., Gyeonggi, Korea) (Figure 4) was employed, utilizing a positive and negative pressure technique after each file change.
case_images: Periapical radiograph confirming master gutta-percha reaching the full working length.
case_images: CRID2024-9962576.005.jpg
case_images: PMC11217572_01_CRID2024-9962576.005.jpg
case_images: fig5
case_images: Confirmation was obtained through a periapical radiograph (Figure 5).
case_images: Modified handle of the spreaders.
case_images: CRID2024-9962576.006.jpg
case_images: PMC11217572_01_CRID2024-9962576.006.jpg
case_images: fig6
case_images: The cold lateral filling technique with an AH Plus sealer (Dentsply Sirona, Charlotte, NC, USA) and modified 31 mm spreaders (MANI Inc., Tochigi, Japan) (Figure 6) was employed, and excess material was carefully removed using a heated gutta-percha condenser (Fast-Pack Pro, Eighteeth, Changzhou City, Jiangsu Province, China).
case_images: Periapical radiograph following the completion of root canal treatment.
case_images: CRID2024-9962576.007.jpg
case_images: PMC11217572_01_CRID2024-9962576.007.jpg
case_images: fig7
case_images: Asia Chemi Teb Co., Tehran, Iran), the pulp chamber was thoroughly cleaned. Another periapical radiograph was taken after the completion of root canal treatment (Figure 7).
case_images: Posttreatment CBCT radiographs in six-month follow-up. (a) Coronal (left) and sagittal (right) slices. (b) 3D model of the treated tooth.
case_images: CRID2024-9962576.008.jpg
case_images: PMC11217572_01_CRID2024-9962576.008.jpg
case_images: fig8
case_images: At the six-month follow-up, both clinical examination and CBCT radiography revealed no periapical abnormalities (Figure 8).
case_images: PRICE 2020 flowchart.
case_images: CRID2024-9962576.009.jpg
case_images: PMC11217572_01_CRID2024-9962576.009.jpg
case_images: fig9
case_images: The patient remained asymptomatic, indicating a successful posttreatment outcome.  Figure 9 displays an overview of the case report using PRICE 2020 flowchart.