Fig. 1

A young patient that had a central incisor fracture due to a trauma eight years ago came to our clinic complaining about a chipping of the ceramic veneer.

Fig. 2

The intraoral examination shows the cervical and buccal chipping of the veneer

Fig. 3

The tooth 1.1 also results longer than the other incisor

Fig. 4

The pre operative X-ray shows an incorrect root canal therapy, with a large preparation that abruptly stops 3 mm short from the apex.

Considering the need to rehabilitate the tooth with a crown, it was decided to retreat the tooth as a first step.

The patient came for the retreatment and I did a multiple isolation in order to have a better control on the axis of the tooth and with the idea of doing the endodontic and restorative treatment in the same appointment

I did the access cavity with a diamond coated bur, then I did the second phase with a ultrasonic tip

The tooth was filled with a carrier based system, so I treated the carrier as if it was a broken tool. With a this ultrasonic tip I did 1 mm of space all around the carrier, then I catched and removed it with a loop device.

After that I removed the remaining gutta percha with a ultrasonic tip and water

At this point I shaped the root canal system with the AF-F One Essential Kit by Fanta Dental.

I set the rows per minute at 400 and the torque at 2.5N. Considering it was a straight canal, I followed the "wide and easy" protocol.

A little extra care was taken while treating the last 3 mm of the root, since the previous therapy had stoped there.

There only was a block that was easy to pass with rotaries, so no particular technique was required to get to the apex.

I used the complete sequence of AF-F files because I wanted to be conservative but at the same time I needed to shape the canal to a sufficient diameter.

I checked the apical gauging and the fit of the gutta percha point

The tooth was directly restored with composite and the patient was referred to the prosthodontist for a crown

Fig. 5

The post endodontic x-ray shows the complete shaping of the root canal system with the preservation of radicular dentine.

Conclusions

When we shape the root canal system we want to be effective and conservative at the same time.

In retreatments we need to adapt to the previous shaping, but we can try to reduce dentine loss by adopting techniques and tools that allow us performing minimally invasive therapies.

Bibliography

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