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A Challenging Endodontic Procedure on a maxillary second molar

March 31, 2017 By Dr Pierre Pizem Leave a Comment

 

Factors affecting the level of difficulty of this endodontic procedure on a  long, remote and heavily calcified second maxillary molar 27 (Irreversible Pulpitis):

  1. Pulp chamber is obliterated making its access more difficult
  2. Narrow root canal entries are embedded in a mass of calcifications, thus, they do have to be located with a microscope
  3. Root canals are narrowed by calcifications thus the odds of blocking, perforating or breaking an instrument are higher than in a tooth presenting with wide canals
  4. To top it all of a second maxillary molar is in a remote area of the mouth making the whole procedure more complicated to perform

Endodontic procedure instrumentation has been performed with Mani stainless K files and ProTaper Universal (Dentsply). Chelator: RC Prep. PUI Irrigation: NaOCl 5%. pulp stones removal with Ultrasonic tip: BUC One from Spartan. P5 (Dentsply) under high magnification and coaxial illumination (Opmi PROergo dental operative microscope from Zeiss) Sealer used: Pulp Canal Sealer. Obturation technique WVC. X Ray Sensors used: CareStream Kodak 6100.

Filed Under: Dental operating microscope (D.O.M.) assisted R.C.T., Extreme endo clinical cases, Pulp stones (denticles), Root canal systems calcifications, D.O.M. versus partially calcified systems

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