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Endodontics Restorative-Conservative Dentistry/ 10 October 2025/ |

Endodontic Management and Adhesive Restoration of maxillary Premolar

Author: Hamza dental center

Email: zahidhamza25@outlook.com

Nationality: Pakistan

Branch: Endodontics, Restorative-Conservative Dentistry

Brand: 3M composite, Palfique LX5 from tokuyama composite for macro core building, Ever x flow from GC, SHOFU composite

Material: Restoration of endo treated tooth, Bio-ceramic sealer, Bisco Bonding agent, Clearfil SE bond , Ever X posterior

Technique: Bio obturation, Composite up layering technique, Class 2 Build Up

This case demonstrates the complete management of a maxillary premolar with irreversible pulpitis and compromised coronal structure. The treatment involved root canal therapy under rubber dam isolation, followed by adhesive restoration to ensure functional and esthetic rehabilitation.

Clinical Workflow

1. Initial Presentation

Patient presented with deep caries and symptoms of irreversible pulpitis in the maxillary premolar.
Preoperative periapical radiograph confirmed pulpal involvement without periapical pathology.
Endodontic treatment with adhesive restoration was planned.

2. Rubber Dam Isolation

Rubber dam was applied for absolute isolation.
This ensured asepsis during endodontic procedures and adhesive restorative steps.

3. Access Opening & Pulpal Exposure

Access cavity preparation was performed to gain straight-line entry.
Pulpal tissue removal confirmed diagnosis.
Hemostasis achieved prior to cleaning and shaping.

4. Cleaning & Shaping

Working length was established radiographically with files in situ.
Biomechanical preparation carried out with rotary NiTi system under irrigation (NaOCl, EDTA).

5. Obturation

The canal was obturated using gutta-percha and bioceramic sealer.
Post-operative radiograph confirmed dense, three-dimensional obturation up to the working length.

6. Adhesive Restoration

Following endodontic treatment, the tooth was restored using composite resin.
Adhesive protocol included selective enamel etching and universal bonding.
Incremental composite placement ensured optimal strength and esthetics.
Proper occlusal anatomy was re-established.

7. Final Outcome

Radiographic and clinical assessment confirmed successful obturation and coronal seal.
Restored tooth achieved functional integrity and esthetic blending with adjacent teeth.

Key Takeaways

Rubber dam isolation is mandatory for both endodontics and adhesive restorations.
Accurate working length determination is critical for successful root canal therapy.
Coronal seal with adhesive composite is equally important for long-term endodontic success.

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Hamza dental center

Welcome to Dr. Hamza Dental Centre, the best dental clinic in Lahore for advanced cosmetic and restorative dentistry , general dental care under the microscope with with with each procedure performed under the rubber Dam isolation ,Led by Dr. Hamza Zahid, BDS, restorative Dentist (London, UK), and a member of the Royal College of Surgeons of England and Scotland, our clinic specializes in smile makeovers with non-invasive veneers that require no drilling. We also offer a range of services, including root canals, gum surgeries, implant surgeries, and basic dental treatments. Awarded the 2022/23 Best Cosmetic Dentist in the USA, Dr. Hamza provides personalized, high-quality care. For a trusted dentist in Lahore, visit us today!