1_Access opening
2_negotiation of canals with k files
3_catch of middle mesial canal
4_cold lateral compaction obturation
5_Immidiate dentin sealing
6_final restoration
Subjective information has been taken from patient history his chief complain was sensitivity to cold and hot and tenderness, so after doing the objective finding by tests, the definitive diagnosis is irreversible pulpitis with apical periodontitis .
The access opening done by endo z bur, then unroofing by ultrasonic tip after finding the 4 canals, there was a catch between mesiolingual and mesiobuccal canal , so after using ultrasonic to remove the dentin shelves there was a middle mesial orifice, the negotiation of it done by K file #6 with EDTA gel then using path files from (#13/0.2, #16.02, #19.02) then continue the shaping and finishing part by rotary files
Here we can see the middle mesial canal has separated portal of exist, and also we can see extra root ( the distolingual root with type 4 canal configuration (Radix entomolaris)).
Invert vs. Positive
Map technique with dentin shade
Final layer of composite restoration done by enamel shade
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