Fig. 1

A 25-year-old female patient presented in our private endodontic office for evaluation of tooth 11, which had a dental trauma 7 years before. 

Her medical history was unremarkable and radiographic examination revealed a calcified canal and previously initiated root canal treatment.

Clinical examination :

  • Negative vitality
  • Positive percussion
  • Positive palpation

The diagnosis was apical periodontitis, after discussing treatment options, we decided on an endodontic treatment. The patient was informed of the pros and cons of the treatment and informed consent was obtained.

Fig. 2

CBCT Slides

Fig. 3

We made the access cavity with an EndoAcces bur and redefined it with ultrasonic tips

Fig. 4

Glide Path  with manual files C + 06 # 08 # 10 #

Scouting Video

Preflaring was performed using Starter, P1 and P2 (MG3 files kit )(Shenzhen Perfect Medical Instruments Co)

Fig. 5

Preflaring sequence

Shaping was performed using G1 and G2 (MG3 files kit )(Shenzhen Perfect Medical Instruments Co)

Fig. 6

Shaping Protocol

Fig. 7

Master Apical File 25#


Obturation with continuous wave technique

Fig. 8

Apical Seal and Backfill

Fig. 9

Final Rx

Full case video


Managing a calcified tooth is a great challenge for an experienced clinicians. The use of a microscope and files with good cutting capacity are essential to successfully solve these types of cases.


Andreasen FM, Zhijie Y, Thomsen BL, Andersen PK. Occurrence of pulp canal obliteration after luxation injuries in the permanent dentition. Endod Dent Traumatol. 1987 Jun;3(3):103-15. doi: 10.1111/j.1600-9657.1987.tb00611.x. PMID: 3476298.

McCabe PS, Dummer PM. Pulp canal obliteration: an endodontic diagnosis and treatment challenge. Int Endod J. 2012 Feb;45(2):177-97. doi: 10.1111/j.1365-2591.2011.01963.x. Epub 2011 Oct 17. PMID: 21999441.