case_images: PMC11821458_01
case_images: Clinical examinations revealing abscess and deep pocket.
case_images: CCR3-13-e70182-g005.jpg
case_images: PMC11821458_01_CCR3-13-e70182-g005.jpg
case_images: ccr370182-fig-0001
case_images: Clinical examinations revealed a pocket depth of 10 mm and a coronal abscess of tooth #30 (Figure 1-1). Additionally, two distinct perforations with relatively extensive lesions were diagnosed: a strip perforation located in the coronal half of the mesiobuccal canal and an apical perforation of the mesiolingual canal (Figure 1-2). Inc., Dublin, CA, USA) (Figures 1-3 and 1-4). After locating the canals' orifices, Canal-filling materials were removed using size one Gates-Glidden (MANI gates drills, MANI, Japan) and H-files (MANI H-files, MANI, Japan). In addition to radiographic images, both perforations were confirmed using an apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) (Figure 1-5). The working length was also assessed with an apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 1-6). CC (SJM, Iran). CC (SJM, Iran) was carried into the perforation site using MAP One carrier (Maillefer, Dentsply, Switzerland), under a dental operating microscope (Carl Zeiss, Meditec Inc., Dublin, CA, USA), and a size 20 finger plugger (Maillefer, Dentsply, Switzerland) was used to compact CC (SJM, Iran) (Figure 1-7). A #25 K-file (Mani Inc., Utsunomiya, Japan) was placed in the mesiobeccal canal with strip perforation as a space maintainer (Figure 1-8). At the 1-week follow-up appointment, the coronal and apical abscesses were still detectable (Figure 1-9). The mesial canal's orifices were covered with Glass-ionomer (GC Fuji I, Tokyo, Japan) to keep the sealing material intact (Figure 1-12), and the pulp chamber was covered with Cavit (Cavisol, Tehran, Iran). Five weeks later, the radiographic examination showed an acceptable root canal filling and complete perforation seal with CC (SJM, Iran) (Figure 1-13). In the 15-month follow-up, tooth #30 showed no signs of inflammation, and the pocket depth was within the normal range (Figure 1-17).
case_images: A periapical radiographic image showing the lesions around the mesial root.
case_images: CCR3-13-e70182-g016.jpg
case_images: PMC11821458_02_CCR3-13-e70182-g016.jpg
case_images: ccr370182-fig-0002
case_images: Clinical examination revealed swelling and abscess in the tissues surrounding the tooth (Figure 2-2). Calcification of the canals was presumed to be the probable cause of the perforations (Figure 2-3). Under magnification (Carl Zeiss, Meditec Inc., Dublin, CA, USA), the temporary restoration was removed (Figure 2-4). After locating all the orifices (Figure 2-5) and estimating the working length with apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 2-6), chemo-mechanical debridement was completed by crown-down technique with M3 rotary files (UDG, Changzhou, China) up to size 25/04 and frequent irrigation with 5.25% sodium hypochlorite and sterile saline. CC (SJM, Iran) following the manufacturers' order using MAP One carrier (Maillefer, Dentsply, Switzerland) and condensed by a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 2-7). Cavit (Cavisol, Tehran, Iran) was placed as the temporary restoration (Figures 2-8 and 2-9).
case_images: After removing the filling material, massive bleeding was visible.
case_images: CCR3-13-e70182-g014.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g014.jpg
case_images: ccr370182-fig-0003
case_images: USA) (Figure 3-3). The retreatment was done using size one Gates-Glidden (MANI gates drills, MANI, Japan) for canals' obturation material and H-files (MANI H-files, MANI, Japan) for perforation's obturation material. Upon locating the canals' orifices, including the missed canal, the working length was determined with the apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 3-4). The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Clinical view of the perforations.
case_images: CCR3-13-e70182-g039.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g039.jpg
case_images: ccr370182-fig-0004
case_images: USA) (Figure 3-3). The retreatment was done using size one Gates-Glidden (MANI gates drills, MANI, Japan) for canals' obturation material and H-files (MANI H-files, MANI, Japan) for perforation's obturation material. Upon locating the canals' orifices, including the missed canal, the working length was determined with the apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 3-4). The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: A periapical radiographic image showing the strip perforation.
case_images: CCR3-13-e70182-g031.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g031.jpg
case_images: ccr370182-fig-0005
case_images: The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Working length assessment and the apical perforation.
case_images: CCR3-13-e70182-g022.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g022.jpg
case_images: ccr370182-fig-0006
case_images: The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Repair of the strip perforation with CC.
case_images: CCR3-13-e70182-g029.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g029.jpg
case_images: ccr370182-fig-0007
case_images: The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: A periapical radiographic image showing the #25 K-file as the space maintainer.
case_images: CCR3-13-e70182-g007.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g007.jpg
case_images: ccr370182-fig-0008
case_images: Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: A periapical radiographic image showing the 10-mm deep pocket of tooth #30.
case_images: CCR3-13-e70182-g003.jpg
case_images: PMC11821458_01_CCR3-13-e70182-g003.jpg
case_images: ccr370182-fig-0009
case_images: At the 1-week follow-up appointment, the coronal and apical abscesses were still detectable (Figure 1-9). The mesial canal's orifices were covered with Glass-ionomer (GC Fuji I, Tokyo, Japan) to keep the sealing material intact (Figure 1-12), and the pulp chamber was covered with Cavit (Cavisol, Tehran, Iran). Five weeks later, the radiographic examination showed an acceptable root canal filling and complete perforation seal with CC (SJM, Iran) (Figure 1-13). In the 15-month follow-up, tooth #30 showed no signs of inflammation, and the pocket depth was within the normal range (Figure 1-17).
case_images: A periapical radiographic image showing the negotiation of the perforated canal to the estimated working length.
case_images: CCR3-13-e70182-g032.jpg
case_images: PMC11821458_01_CCR3-13-e70182-g032.jpg
case_images: ccr370182-fig-0010
case_images: The mesial canal's orifices were covered with Glass-ionomer (GC Fuji I, Tokyo, Japan) to keep the sealing material intact (Figure 1-12), and the pulp chamber was covered with Cavit (Cavisol, Tehran, Iran). Five weeks later, the radiographic examination showed an acceptable root canal filling and complete perforation seal with CC (SJM, Iran) (Figure 1-13). In the 15-month follow-up, tooth #30 showed no signs of inflammation, and the pocket depth was within the normal range (Figure 1-17).
case_images: Repair of the perforations with CC.
case_images: CCR3-13-e70182-g002.jpg
case_images: PMC11821458_01_CCR3-13-e70182-g002.jpg
case_images: ccr370182-fig-0011
case_images: The mesial canal's orifices were covered with Glass-ionomer (GC Fuji I, Tokyo, Japan) to keep the sealing material intact (Figure 1-12), and the pulp chamber was covered with Cavit (Cavisol, Tehran, Iran). Five weeks later, the radiographic examination showed an acceptable root canal filling and complete perforation seal with CC (SJM, Iran) (Figure 1-13). In the 15-month follow-up, tooth #30 showed no signs of inflammation, and the pocket depth was within the normal range (Figure 1-17).
case_images: Covering CC with Glass-ionomer.
case_images: CCR3-13-e70182-g028.jpg
case_images: PMC11821458_01_CCR3-13-e70182-g028.jpg
case_images: ccr370182-fig-0012
case_images: The mesial canal's orifices were covered with Glass-ionomer (GC Fuji I, Tokyo, Japan) to keep the sealing material intact (Figure 1-12), and the pulp chamber was covered with Cavit (Cavisol, Tehran, Iran). Five weeks later, the radiographic examination showed an acceptable root canal filling and complete perforation seal with CC (SJM, Iran) (Figure 1-13). In the 15-month follow-up, tooth #30 showed no signs of inflammation, and the pocket depth was within the normal range (Figure 1-17).
case_images: Postoperative radiograph.
case_images: CCR3-13-e70182-g021.jpg
case_images: PMC11821458_01_CCR3-13-e70182-g021.jpg
case_images: ccr370182-fig-0013
case_images: Five weeks later, the radiographic examination showed an acceptable root canal filling and complete perforation seal with CC (SJM, Iran) (Figure 1-13). In the 15-month follow-up, tooth #30 showed no signs of inflammation, and the pocket depth was within the normal range (Figure 1-17).
case_images: Twelve-month follow-up examinations exhibiting tissue healing with no signs of inflammation.
case_images: CCR3-13-e70182-g006.jpg
case_images: PMC11821458_01_CCR3-13-e70182-g006.jpg
case_images: ccr370182-fig-0014
case_images: In the 15-month follow-up, tooth #30 showed no signs of inflammation, and the pocket depth was within the normal range (Figure 1-17).
case_images: Twelve-month postoperative radiograph showing favorable healing of the lesions.
case_images: CCR3-13-e70182-g004.jpg
case_images: PMC11821458_01_CCR3-13-e70182-g004.jpg
case_images: ccr370182-fig-0015
case_images: In the 15-month follow-up, tooth #30 showed no signs of inflammation, and the pocket depth was within the normal range (Figure 1-17).
case_images: PMC11821458_02
case_images: A periapical radiographic image showing the lesions around the mesial root.
case_images: CCR3-13-e70182-g016.jpg
case_images: PMC11821458_02_CCR3-13-e70182-g016.jpg
case_images: ccr370182-fig-0002
case_images: Clinical examination revealed swelling and abscess in the tissues surrounding the tooth (Figure 2-2). Calcification of the canals was presumed to be the probable cause of the perforations (Figure 2-3). Under magnification (Carl Zeiss, Meditec Inc., Dublin, CA, USA), the temporary restoration was removed (Figure 2-4). After locating all the orifices (Figure 2-5) and estimating the working length with apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 2-6), chemo-mechanical debridement was completed by crown-down technique with M3 rotary files (UDG, Changzhou, China) up to size 25/04 and frequent irrigation with 5.25% sodium hypochlorite and sterile saline. CC (SJM, Iran) following the manufacturers' order using MAP One carrier (Maillefer, Dentsply, Switzerland) and condensed by a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 2-7). Cavit (Cavisol, Tehran, Iran) was placed as the temporary restoration (Figures 2-8 and 2-9).
case_images: After removing the filling material, massive bleeding was visible.
case_images: CCR3-13-e70182-g014.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g014.jpg
case_images: ccr370182-fig-0003
case_images: USA) (Figure 3-3). The retreatment was done using size one Gates-Glidden (MANI gates drills, MANI, Japan) for canals' obturation material and H-files (MANI H-files, MANI, Japan) for perforation's obturation material. Upon locating the canals' orifices, including the missed canal, the working length was determined with the apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 3-4). The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Clinical view of the perforations.
case_images: CCR3-13-e70182-g039.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g039.jpg
case_images: ccr370182-fig-0004
case_images: USA) (Figure 3-3). The retreatment was done using size one Gates-Glidden (MANI gates drills, MANI, Japan) for canals' obturation material and H-files (MANI H-files, MANI, Japan) for perforation's obturation material. Upon locating the canals' orifices, including the missed canal, the working length was determined with the apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 3-4). The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: A periapical radiographic image showing the strip perforation.
case_images: CCR3-13-e70182-g031.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g031.jpg
case_images: ccr370182-fig-0005
case_images: The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Working length assessment and the apical perforation.
case_images: CCR3-13-e70182-g022.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g022.jpg
case_images: ccr370182-fig-0006
case_images: The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Repair of the strip perforation with CC.
case_images: CCR3-13-e70182-g029.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g029.jpg
case_images: ccr370182-fig-0007
case_images: The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: PMC11821458_03
case_images: After removing the filling material, massive bleeding was visible.
case_images: CCR3-13-e70182-g014.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g014.jpg
case_images: ccr370182-fig-0003
case_images: USA) (Figure 3-3). The retreatment was done using size one Gates-Glidden (MANI gates drills, MANI, Japan) for canals' obturation material and H-files (MANI H-files, MANI, Japan) for perforation's obturation material. Upon locating the canals' orifices, including the missed canal, the working length was determined with the apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 3-4). The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Clinical view of the perforations.
case_images: CCR3-13-e70182-g039.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g039.jpg
case_images: ccr370182-fig-0004
case_images: USA) (Figure 3-3). The retreatment was done using size one Gates-Glidden (MANI gates drills, MANI, Japan) for canals' obturation material and H-files (MANI H-files, MANI, Japan) for perforation's obturation material. Upon locating the canals' orifices, including the missed canal, the working length was determined with the apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England) and radiographic image (Figure 3-4). The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: A periapical radiographic image showing the strip perforation.
case_images: CCR3-13-e70182-g031.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g031.jpg
case_images: ccr370182-fig-0005
case_images: The perforations were sealed with CC (SJM, Iran) following the manufacturer's instructions using MAP One carrier (Maillefer, Dentsply, Switzerland) and a #20 finger plugger (Maillefer, Dentsply, Switzerland) (Figure 3-5). The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Working length assessment and the apical perforation.
case_images: CCR3-13-e70182-g022.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g022.jpg
case_images: ccr370182-fig-0006
case_images: The Cavit (Cavisol, Tehran, Iran) was used as the temporary restoration (Figure 3-6). The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: Repair of the strip perforation with CC.
case_images: CCR3-13-e70182-g029.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g029.jpg
case_images: ccr370182-fig-0007
case_images: The examinations displayed elimination of BOP, reduced probing depth to 3 mm, and significant dwindle of the lesions, indicating tissue regeneration and healing (Figure 3-7). Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).
case_images: A periapical radiographic image showing the #25 K-file as the space maintainer.
case_images: CCR3-13-e70182-g007.jpg
case_images: PMC11821458_03_CCR3-13-e70182-g007.jpg
case_images: ccr370182-fig-0008
case_images: Furthermore, the control radiograph showed favorable healing of the bone and lesions (Figure 3-8).