Root Canal “System”Root Canal “System”

The complexity of the root canal system cannot be The complexity of the root canal system cannot be underestimated. All portals of exit must be sealed to underestimated. All portals of exit must be sealed to ensure elimination of periradicular pathologyensure elimination of periradicular pathology

The complexity of the root canal system cannot be The complexity of the root canal system cannot be underestimated. All portals of exit must be sealed to underestimated. All portals of exit must be sealed to ensure elimination of periradicular pathologyensure elimination of periradicular pathology

RetreatmentRetreatmentRetreatmentRetreatment

RetreatmentRetreatmentRetreatmentRetreatment

RetreatmentRetreatmentRetreatmentRetreatment

RetreatmentRetreatmentRetreatmentRetreatment

Flexipost cemented in Flexipost cemented in palatal canal – ultrasonic palatal canal – ultrasonic removalremoval

MB2 orifice not identified MB2 orifice not identified previouslypreviously

contaminants evident in contaminants evident in other canalsother canals

Flexipost cemented in Flexipost cemented in palatal canal – ultrasonic palatal canal – ultrasonic removalremoval

MB2 orifice not identified MB2 orifice not identified previouslypreviously

contaminants evident in contaminants evident in other canalsother canals

RetreatmentRetreatment

post removed – all canals post removed – all canals identified and negotiatedidentified and negotiated

Class I inlay preparation Class I inlay preparation initiated for NiTi accessibilityinitiated for NiTi accessibility

heated NaOCl (150heated NaOCl (150oo F) and F) and EDTA left to soak in chamber EDTA left to soak in chamber and canal system throughout and canal system throughout procedureprocedure

post removed – all canals post removed – all canals identified and negotiatedidentified and negotiated

Class I inlay preparation Class I inlay preparation initiated for NiTi accessibilityinitiated for NiTi accessibility

heated NaOCl (150heated NaOCl (150oo F) and F) and EDTA left to soak in chamber EDTA left to soak in chamber and canal system throughout and canal system throughout procedureprocedure

RetreatmentRetreatment

canals shaped, cleaned and canals shaped, cleaned and obturated obturated

gutta-percha seal to orifice gutta-percha seal to orifice interface with chamber floorinterface with chamber floor

bristle brush and ethanol used bristle brush and ethanol used to remove sealer from chamberto remove sealer from chamber

chamber then etched with chamber then etched with phosphoric acid in preparation phosphoric acid in preparation for sealing of the chamber floor for sealing of the chamber floor and canal orificesand canal orifices

canals shaped, cleaned and canals shaped, cleaned and obturated obturated

gutta-percha seal to orifice gutta-percha seal to orifice interface with chamber floorinterface with chamber floor

bristle brush and ethanol used bristle brush and ethanol used to remove sealer from chamberto remove sealer from chamber

chamber then etched with chamber then etched with phosphoric acid in preparation phosphoric acid in preparation for sealing of the chamber floor for sealing of the chamber floor and canal orificesand canal orifices

RetreatmentRetreatment

dentinal adhesive (PQ1) used in dentinal adhesive (PQ1) used in conjunction with Permaflo to create conjunction with Permaflo to create bonded composite layer over the bonded composite layer over the canal entrances to the root canal canal entrances to the root canal system as well as close any furcal system as well as close any furcal canalscanals

further layering of core material can further layering of core material can be applied after micro-etchingbe applied after micro-etching

bonded core depth sufficient to bonded core depth sufficient to preclude need for post placementpreclude need for post placement

dentinal adhesive (PQ1) used in dentinal adhesive (PQ1) used in conjunction with Permaflo to create conjunction with Permaflo to create bonded composite layer over the bonded composite layer over the canal entrances to the root canal canal entrances to the root canal system as well as close any furcal system as well as close any furcal canalscanals

further layering of core material can further layering of core material can be applied after micro-etchingbe applied after micro-etching

bonded core depth sufficient to bonded core depth sufficient to preclude need for post placementpreclude need for post placement