Fig. 1

Female 63 yrs old , the patient has been referred to the office for a problem on distal root in second lower molar , the patient has pain during the chewing and radiographically is evident an overfilling due to a wrong obturation technique . 

Two  different operative options , endodontic surgery or non surgical retreatment , but in this case we preferred the retreatment option for the unfavorable anatomy and the difficulty in the surgical access even in presence of materials beyond the apex .

Fig. 2

In the CBCT the anatomy situation is clear , it’s possible to see the relationships between the apex and the mandibular nerve as well as the materials over the apex.

Fig. 3

CBCT cross sections

Fig. 4

Green Arrows show the overextended material in two different CBCT views

Fig. 5

We removed the big screw post thanks to the a special screw driver and after that all the cement using ultrasonic tips , in the previous treatment the colleague used thermafil technique and part of the core is out of the apex . 

Fig. 6

After the disassembling we can see the cement in the canal and the plastic core that occlude the space

Fig. 7

When the disassembling has been completed , the canal shaped and cleaned , we positioned a collagen matrix beyond the foramen to obtain a better control during  the apical plug . 

Fig. 8


Fig. 9

the cement must be mixed correctly with the right powder liquid ratio

Fig. 10

MTA mixed and ready to use 

Fig. 11

The MAP-ONE bring the MTA in the apical one third 

Fig. 12

Using the MAP-ONE  it’s easy to bring the MTA in the apical one third , subsequently the material is pushed and adapted gently to the foramen, using a paper point .

Fig. 13

 Post-op xray , the plug is perfectly positioned , no overfilling and the obturation is tridimensional 

Fig. 14

With MAP system it's possible to obtain a MTA block, 5 mm leght ideal to do  apical plug


To obtain a perfect adaptation of the cement in the apical one third is necessary bring the right amount of material in the apex and at the right level , that’s why the use of MAP-ONE is mandatory


Torabinejad M, Parirokh M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part II: other clinical applications and complications. Int Endod J. 2018 Mar;51(3):284-317.

Parirokh M, Torabinejad M, Dummer PMH. Mineral trioxide aggregate and other bioactive endodontic cements: an updated overview - part I: vital pulp therapy. Int Endod J. 2018 Feb;51(2):177-205.