An intricate endodontic therapy to perform in order to preserve a very painful tooth, patient was taking 3 X 200mg Ibuprofen Pills every 3 hours in order to get through the preceding night. Serous exudate accumulation resulted in mucosa swelling.
This type of root canal treatment has a high level of difficulty because calcified canal shaping is prone to endodontic file torsional fracture inside the tooth. Calcified root canals entries where located with the help of a Carl Zeiss Microscope. These where embedded in a mass of pulpstones and calcifications which had to be removed with ultrasonic tips. Shaping performed with stainless steel K hand files 06, 08, 10, 15, 20,25, 30 from Maillefer (Envelope of motion technique and lots of chelating agent). Calcium Hydroxide Antibacterial gel insertion was mandatory to control infection within the root canal system. This gel has been removed in a subsequent appointment and replaced by a permanent root canal filling. (Cold lateral condensation gutta + Pup Canal Sealer)