An appreciation of the anatomic complexity of the root canal system is essential at every step of endodontic treatment. Endodontic treatment of teeth with unusual root canal anatomy presents a unique challenge. This clinical case report presents the application of cone beam computed tomography as a useful imaging technique in endodontics for the management of teeth with aberrant anatomy. Failure to detect an extra canal may lead to treatment failure. The current report presents the management of a previously endodontically treated maxillary first molar with missed additional mesiobuccal and distobuccal canals.
Keywords: CBCT, Canal Morphology, Maxillary molar, Missed canal, Retreatment.
Aim:
The aim of this study was to evaluate and compare the depth and percentage of sealer penetration into dentinal tubules using extracanal and intracanal heated NaOCl in the irrigation protocol using a confocal laser scanning microscope.
Methods:
Thirty extracted central incisors prepared till F4 ProTaper Gold were randomly distributed into three groups (n = 10 each) depending on the final irrigation protocol. Group C – nonheated 3% NaOCl, group EC – extracanal heated 3% NaOCl, and group IC – intracanal heated 3% NaOCl. Final irrigation with different warming protocols along with sonic activation was performed. Canals were obturated with standardized F4 Protaper Gold gutta-percha cone coated with AH Plus sealer labeled with Rhodamine B dye. The transverse sections of samples at different levels were examined on a confocal microscope and analyzed using IOB software. Unpaired “t” test and Mann–Whitney U test were used for intergroup comparison; P < 0.05.
Results:
The percentage of sealer penetration was significantly lower in group C as compared to group IC and EC at the coronal and middle third. Group C showed a lower depth of sealer penetration as compared to group EC and IC at all levels. The percentage and depth of sealer penetration were not significantly different between group EC and IC at all levels.
Conclusion:
Extracanal and intracanal heating of NaOCl significantly improves the percentage and depth of AH Plus sealer penetration in dentinal tubules.
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