Fig. 1

Tooth #46

Diagnosis of Pulp Necrosis and symptomatic Apical periodontitis was established for the first mandibular molar on a 35 years old patient with clear medical history.

The pre-op radiograph indicated a a challenging anatomy on the mesial root with long and narrow canals that required extra attention and care to negotiate them.

Fig. 2

After removing the existing composite restoration and establishing  a correct access into pulp chamber, all canals were identified and  WL was determined.

Fig. 3

Intra operative photo of Access and Identification of 4 canals.

Fig. 4

Master cone fit. A conservative preparation is noted.

Canals prepared and ready for obturation

Fig. 5

Post- operative radiograph of tooth #46 obdurated with single cone  and BC sealer with cold hydraulic condensation technique.

Fig. 6

Radiographic work flow of tooth #46.

Fig. 7

Harmony Minimally Invasive Kit suitable for narrow and calcified canals.

management of the case

Conclusions

The new sequence of files from Fanta, Harmony, appears to be effective in dealing with narrow and calcified canals resulting in a successful outcome while respecting and maintaining the original anatomy of the canals.

Bibliography

1.Kaveh Nasiri, Karl-Thomas  Wrbas. Management of calcified root canal during root canal therapy. J Dent Sci. 2023 Jun 27;18(4):1931-1932.

2. McCabe PS, Dummer PMH. Pulp canal Obliteration:An endodontic diagnosis and treatment challenge. Int Endod J 2011;45:177-197.

3.Chaniotis A, Zapata-Ordinola R. Present status and future directions: Management of curved and calcified root canals.  Int Endod J 2022; 55:656-684

4.Divya S.b, Sandeep A.H. Decision tree analysis on management of calcified canals. Int J Health Sci; 2022:6(23) 2174-2183