case_images: PMC4293587_01
case_images: A) Preoperative radiography of the mandibular left second premolar; B) Root canal dressing with calcium hydroxide paste; C) Canal obturation after induction of apical barrier; D) Six-year follow-up
case_images: iej-10-079-g001.jpg
case_images: PMC4293587_01_iej-10-079-g001.jpg
case_images: F1
case_images: Radiographic examination revealed the presence of a periapical lesion located lateral to the apex of the tooth #35 and incomplete root development (Figure 1A). Then the canal was filled with creamy mixture of CH powder (pro analysis, Labsynth Produtos para Laboratorio LTDA, Diadema, SP, Brazil) and saline and the tooth was temporarily restored (Figure 1B). Time, Kerr Sybron Dental Specialties, California, USA). Then the thermoplasticized vertical condensation of gutta-percha was employed using the medium tip of a System B electric device (SybronEndo, CA, USA) supplemented with the use of an Obtura II device (Corp, Fenton, MO, USA) (Figure 1C).  There were also radiographic signs of lateral and apical root closure (Figure 1D).
case_images: PMC4293587_02
case_images: A) Operative radiography of the maxillary left central incisor with a #140 K-file; B) MTA-specific points inside the canal; C) placement of the MTA apical plug; D) Canal backfilling E) Six years later
case_images: iej-10-079-g002.jpg
case_images: PMC4293587_02_iej-10-079-g002.jpg
case_images: F2
case_images: Tokyo, Japan) and was confirmed with a radiographic image and a #140 K-file (Figure 2A). Then the canal was gently irrigated with 2.5% NaOCl carried with a 25-gauge needle connected to a disposable syringe with simultaneous aspiration. A radiographic image was taken with the MTA-specific points (Apice, Belo Horizonte, Brazil) placed in the canal to ensure correct positioning (Figure 2B). Using Schilder pluggers (Odous de Deus, Belo Horizonte, MG, Brazil) a 4 mm-thick MTA apical plug was gently applied and packed into the apical segment and confirmation radiography was taken (Figure 2C). Then, the additional 3 mm of the canal was obturated using an Obtura II system and PCS EWT sealer (Figure 2D). 