Symptomatic apical lesion on mesio vestibular root of first upper left molar. Pre operative X ray film shows a tough post to remove and a pre-existing root canal treatment performed 20 years ago. First appointment: Crown and casted post removal: MB1,P, DB retreatment and MB2 locating cleaning and shaping. Complete canal system is then filled with Ca(OH)2 and a provisionnal post and crown cemented with Temp Bond insure a good seal for the next ten days. Second appointment : Final obturation with Pulp Canal sealer lateral and vertical packing of gutta percha One year post-op X Ray shows nice bone healing It's worth it to note that in this case, MB and MB2 apex anastomosis did not prevent this patient from getting an AAA. In first upper molars, an MB2 is present in 93% of the cases. Thus, to always strive to find, clean and shape MB2 is becoming the standard of care.
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