Root canal treatment of a restored tooth.

Case presentation :

The upper left first molar #26 has a large coronal alloy restoration. This tooth has been the source of intense episodic pain. A diagnosis of irreversible pulpitis was made and the tooth was scheduled for Initial Endodontic Treatment.

The preoperative radiograph shows:

- Extensive coronal restorations in all of the teeth in this quadrant
- The presence of a post crown in an un-root filled premolar tooth
- Generalised horizontal bone loss
- In the tooth #26 we can see a large coronal restoration
- Significant pulpal and canal sclerosis

This tooth represents a challenging endodontic treatment.

Initial Endodontic treatment

- Local anaesthesia
- Isolation with rubber dam
- Accessing the pulp chamber
- Localization of the canal orifices with a DG 16 probe under magnification and with thorough irrigation
- Opening of the root canal entrances with Neoniti C1 no. 25/.12 and then irrigation
- Initial glidepath with stainless steel #10 K-files
- Completing glidepath with Neoniti GPS no. 15/.03 , and irrigation
- Measuring the Working Length (WL) using an apex locator
- Shaping the root canals with Neoniti A1 no. 20/.06, then A1 no. 25/.06, and irrigation
- Drying of the root canals
- Obturation by pre-calibrated master cones
- Final radiographic examination

Comments

The use of the Neoniti system enabled the treatment to be completed efficiently in a single visit. The shaping respects the natural shapes and curvatures. Careful measurement and control of the working length resulted in a well cleaned and obturated canal system with a very satisfying final result.

The Neoniti shaping procedure, allows complex shapes to be prepared routinely and hassle-free. Open the canals with Neoniti C1 no. 25/.12, establish root canal patency and glide path with Neoniti GPS no. 15/.03, and complete the canal shaping with Neoniti no. 20/.06 and no. 25/.06.