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ePaper created 2018-05-16, 11:45:19 | version 1.38.0
Fig. 10 Fig. 11 Fig. 12 Fig. 10 Working length radiographs. Fig. 11 Final radiograph. Fig. 12 Three-month follow-up radiograph. Fig. 13 Level of the cemento- enamel junction (CEJ). Fig. 14 Incisal access allows straight-line access to locate the pulp chamber. Fig. 15 Color changes in pulp chamber. Fig. 13 Fig. 14 Fig. 15 (primary dentin; Fig. 6). After finding a ring of calcification (Fig. 7), we use an ultrasonic tip to have a more controlled cutting action and better visual control; in this clinical case, we selected the Red- Star RS-2 ultrasonic tip (Kerr Endodon- tics). In such a clinical situation, it is import- ant to follow a basic sequence of irrigate and scrub with sodium hypochlorite/ EDTA, dry, observe and cut until one can find the root canal. Radiographic control during this procedure is fundamental in order to avoid any mishap. When the root canal entrance was iden- tified (Fig. 8), a short (21 mm in length) and more rigid hand file was selected to allow more tactile control and a more ef- fective cutting action. The root canal was instrumented with size 8, 10, 12 and 15 D Finders (Mani Inc.) to obtain a manual glide path using the M4 Safety Handpiece (Kerr Endodontics; Fig. 9). Working length radiographs were cap- tured (Fig. 10). Cleaning and shaping were performed using TF Adaptive (Kerr Endo- dontics) up to size 25.06 with the Ele- ments Motor (Kerr Endodontics) in Adap- tive Motion. Irrigation was performed during the entire treatment with 5.25% sodium hypochlorite. A final irrigation protocol was done with 17% EDTA and 5.25% sodium hypochlorite, and irrigant was activated with the manual dynamic activation technique. The canals were thoroughly dried and obturation per- formed using Autofit 4% gutta-percha cones (Kerr) and AH Plus (Dentsply Maillefer), employing the continuous wave of condensation technique with the Elements Obturation Unit (Kerr Endodon- tics). The pulp chamber was sealed with Ionoseal (VOCO) and a temporary resto- ration was performed (Fig. 11). The patient was referred to his dentist for the perma- nent coronal restoration. At a follow-up visit after three months, the tooth was asymptomatic (Fig. 12). 52 — issue 2018 Endodontics Article