Fig. 1

Clinical case 

Clinical data

Patient with pain in the lower right jaw.

There were many reasons:

  1. The third lower right molar was impacted
  2. The second lower molar – necrotic tooth
  3. The firs lower molar had aproximal decay
  4. The second lower premolar – distal deep decay
Fig. 2

Initial situation of the case

Fig. 3

Pre endo build up 


Root canal treatment in one visit

Fig. 4

X-ray after root canal treatment

Fig. 5

Surgical removal of lower right third molar

Fig. 6

Tooth separation

Fig. 7

Removing the tooth

Fig. 8

Distal build up with composit of tooth 47

Fig. 9

Completion of the surgical part

Fig. 10

Restoration of tooth 45 with composit 

Fig. 11


Fig. 12

Completion of multidisciplinary treatmentEndodontic treatment of lower right second molar surgical removing of tooth lower right third molar composit restoration of lower right second premolar

Fig. 13

Final x-ray 


Multidisciplinary approaches gives us full control of the various situations we have to deal with in our daily work, on the other hand these types of approaches make us more efficient and safer.

These situations need to be well plannned in advance and have a reasonable chronology.

Multidisciplinary approaches require knowledge and skills of the dentist, as well as cooperation from the patient, and when these conditions are met then success and long-term prognosis will not be lacking


Mauro Venturi,MD,DDS,* Roberto Di enardo, DDS, Carlo Prati MD,DDS,PhD,* and Lorenzo Breschi, DDS,PhD. An In Vitro Model to Investigate Filling of Lateral Canals, JOE Volume 31, Number 12, December 2005.

Chad M. Reader, DDS, Van T. Himel, DDS, Lisa P.Germain,DDS, and Michael M.Hoen, DDS

Effect of Three Obturation Techniques on the Filling of Lateral Canals and the Main Canal. Journal of Endodontics, August 1993

N.J.M. Opdam, F.H. van de Sande, E. Bronkhorst, M.S Cenci, P. Bottenberg, U. Pallesen, P. Gaengler, A. Lindberg, M.C.D.N.J.M. Huysmans and J.W van Dijken. Longevity of Posterior Composite Restorations: A Systematic Review and Meta-analysis, Journal of Dental Research 2014.

Jay W.Fridman, DDS, MPH. The Prophylactic Extraction of Third Molars: A Public Health Hazard. American Journal of Public Health 2007 Vol 97.

Gary F.Bouloux, MD, BDS, MDSc, FRACDS, FRACDS(OMS), Martin B. Steed, DDS, Vincent J. Perciaccante, DDS. Complicationss of Third Molar Surgery. Oral Maxillofacial Surg Clin N Am 19 ( 2007 ) 117 – 128.