Fig. 1

The pre operative orthopantomography shows the presence of severely worn teeth due to bruxism. The patient came to my attention complaining about acute, spontaneous pain in the lower right hemi-arch.

Fig. 2

The pre operative periapical X-ray shows the presence of a decay and the compromission of the pulp. The diagnosis is irreversible pulpitis of the lower right first premolar, the therapy is endodontic treatment.

Fig. 3

After doing the anesthesia and isolating the tooth, the access cavity was done. In this case in was enough to remove all the decay to gain straight accesso to the root canal system.

Fig. 4

A mechanical glide path was done by using a series of Ni-Ti instruments short to the estimated WL. First of all a 13.03 instrument was used.

Fig. 5

Then it was possible to use a 20.04 file, without applying pressure, just to pre-flare the root canal.

Fig. 6

Since the anatomy of the root allowed it, a 25.06 file was used in the same way.

Fig. 7

The working length was recorded with a #10 K-file and electronic apex locator.

After recording the working length, the selected rotary file system was used to shape the root canal up to 35 .04

Fig. 8

After that, the irrigation phase was carried out with 5,25% Sodium Hypochlorite.

The video shows the irrigant in action

In order to give a boost to the effect of the irrigant, a ultrasonic K-File was used to activate it.

Fig. 9

Since it was chosen to obturate the root canal system with the WVC technique, the selected gutta percha point was tried until it fit the root canal preparation.

Fig. 10

The root canal was dried with sterile paper points. The presence of a small blood spot on the side of the paper point suggests the presence of a lateral canal in that area.

Fig. 11

The canal is clean, dry and ready to be filled.

It was decided to use EssenSeal (Produits Dentaires SA, Vevey, Switzerland) as a root canal sealer.

EssenSeal (Produits Dentaires SA, Vevey, Switzerland) is a powder-liquid cement highly flowable with low paste thickness, that should be mixed according with manufacturer’s instruction, 1 drop of liquid with 1 of the provided spoon of powder.

The powder should be gradually incorporated into the liquid and the product should be mixed until it reaches a creamy consistency and a shiny appearance.

Fig. 12

The sealer was applied into the root canal by means of a paper point.

Fig. 13

The filling was done with the warm vertical compaction of the gutta percha technique.

Fig. 14

Post-operative X-ray after the restoration


After the treatment the patient was free from pain. He was scheduled for a treatment plan involving the occlusal rehabilitation of the whole mouth.

EssenSeal (Produits Dentaires SA, Vevey, Switzerland), besides the good handling and the pleasant scent, has the capability to penetrate smoothly into the root canals, filling also the lateral canals without any voids.


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