Fig. 1

A 55 yrs old man came to our office complaining discomfort related to the second upper left premolar.

Pulp diagnosis of symptomatic irreversible pulpitis.

Dental destruction can be observed, which would imply a challenging rubber dam isolation.

Fig. 2

Pre operative radiograph

Fig. 3

We perform multiple isolation and place the clamp on a posterior tooth, this will allow us to work more freely and be able to place our matrix band system.

After the rubberdam placement the old composite restoration was carefully removed using a cylindrical medium-grain bur and the margins were clean and smoothened using a silicon bur.

The matrix band system is placed around the tooth, ensuring perfect closure of the distal margin.

Fig. 4

In this step, the use of a high-fill, light-curing restorative material is recommended instead of a dual-cure composite cement due to its superior mechanical properties and wear resistance.

Fig. 5

After the build up or the creation of the distal wall, we can practically work comfortably in root canal treatment.

Thus we prevent saliva filtration, irrigant filtration.

Fig. 6

Instrumentation with martensitic files with taper 04.

Fig. 7

Working length 

Fig. 8

Irrigation with 3% sodium hypochlorite, and ultrasonic activation.

Fig. 9

Ready for the obturation

Fig. 10

Master cone fit

Fig. 11

Hydraulic sealer injection

Note that the canals confluent with each other.

Fig. 12

Obturation done.

Clean the excess of gutapercha and sealer is a very important step for a correct adhesive protocol step.

Fig. 13

Post-op X-Ray with the final restoration and a proper contact point.

Fig. 14

Endo from A to Z


As endodontists o clinicians, we must do optimal treatments or in the best possible way, this implies that we must know how to handle different clinical situations, in this case, a restorative procedure before endodontics, will simplify and optimize our treatments.

In endodontic treatment, multiple variables can affect the outcome of a case. The use of pre-endodontic build-up will enhance by preventing marginal leakage before, during, and after treatment that is provided prior to placing a final restoration.


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