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Tooth 46,4 canals,4 apexes,Vertical condensation - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are -
From: Nazariy Mykhaylyuk
Sent: Saturday, August 29, 2009 8:12 PM
Subject: [roots] My first case here.

Hello everyone.

This is my first case here. Dont be too stricked :)
I'm a young dentist. Tooth 46, 4 canals - 4 apexes. Vertical condensation 
- Resilon (Sybron Endo). It will be very interesting for me to read any 
advices or just interesting thoughts. - Nazariy Mykhaylyuk

Nice work - tell  us more about your methods, how many visits and so on  
- Simon Bender

Thanks. I was working using hypochloryde 6% (15 ml for this case), 
RC-Prep, K3-files (with Morita), ultrasound, scope - Leica M300.Medial 
canals finished at 4/25, distal canals - 4/30 and 4/25. Canals were narrow.
Filled with resilon (Obturation unit - Sybron Endo). What more detail 
can I add? Ill be glad to do that. - Nazariy

Nazariy - you're in the Ukraine??
Fantastic...................scopes, high end cameras, Real Seal.........
..wonder if we'd find that in Nebraska or dare I say Winnipeg - maybe an 
F150 Harley Davidson..........good on you lad.............Kendo

Hi Nazariy, Very nice case. Thinking if it`s just the first one...we can 
expect great cases from you. kind regds from Sao Paulo - Brazil, Sergio.

with 2 distal canals I would look very hard for a middle mesial canal.  
Trough between the mesial orifices and flare back the entire mesial wall.

Looks great, hope the mm canal is not there.  Beautiful job with 
restorative, direct resin? - Dan Shalkey

+1 on Dan's observation. - Mark

Daniel, thank you for the advice, I will use in future. Hope there was 
no mm in this case :) It was a direct restorative, resin - Estelite Sigma 
(Tokuyama Dental - Japan) - Nazariy Mykhaylyuk

Daniel, thank you for the advice, I will use in future. Hope there was 
no mm in this case :) It was a direct restorative, resin - Estelite Sigma 
Tokuyama Dental - Japan) -  Nazariy Mykhaylyuk

Nice work Nazariy!. I would take Dan's advice on troughing in-between the 
orifice for extra canals or Portals of entry( POE's) + tissue space 
(Lodging and boarding) for recurrent infection. Excellent finish on the resin...
hopefully a full coverage is planned to cover your effort - Rajiv Patel

Nice case, my initial thought looking at your access was MM?, and then the 
e-mails starting coming in. I just signed on to this forum and I have been 
following these e-mails for a couple of weeks now. I have definitely learnt 
a lot from the short time I have been onboard.  Well I figured I would 
contribute with my first case, unfortunately I don't have pictures of my access, 
and as a matter of fact I don't even have my initial radiograph here to upload.  
Anyway, let me know what you think....

Also, this past month I treated two maxillary second molars with two palatal 
roots! I plan on sending those in within the next couple of weeks - Joe Bruckner

Hello Joe. Thank you for your position. If you mean the access to the canals 
in the distal root, it is no the best one, I agree. A lesson for future - Nazariy

Hey Nazariy, I was just refering to the mesial wall just to confirm if MM is 
there u probably could have brought that wall more mesial so the floor is flush
with the wall, run an ultrasonic in the possible isthmus btw ML and MB and then 
see if you get a stick there - Joe

Beautiful looking case - impressive curvature management - details? - Simon Bender

Thanks,  I used gg #3, S1 in middle third, 10 c-file to length, 15 k-file, 
20 k-file, S1, S2,  20 K-file, 25 k-file, 30 k-file, 30/.06 GTx.  Only two 
canals in this third molar - Joe Bruckner

Hey, Joe are you in the Stony Brook residency by any chance, just curious, 
nice management of some tough curves. Did you try to look for another mesial. 
Here`s one from this week. - Ivan Vyuchnov

Well, Ivan, I didn't say it's poor, I said that dentists from other countries think it is :). My city is right in the geografical center of Europe - Nazariy

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Cvek pulpotomy

Middle mesial

Endo misdiagnosis

MTA retrofill

Resin core

BW importance

Bicuspid tooth

Necrotic #8 treatment

Finding MB2 / MB3

Deep in a canal

Broken file retrieval

Molar cases

Pushed over apex

MB2 and palatal canal

Long lower third

Veneer cases

CT Implant surgury

Weird Anatomy

Apical trifurcation

Canal and Ultrasonics

Cotton stuffed chamber

Pulp floor sandblasting

Silver point removal

Difficult acute curve

Marked swelling

5 canaled premolar

Sealer overextension

Complex anatomy

Secondary caries

Zygomatic arch

Confluent mesials

LL 1st molar (#19)

Shaping vs Cleaning

First bicuspid

In Vivo mesial view

Inaccesible canals

Premolar 45

Ortho and implant


Lateral incisor


Churning irrigant

Cold lateral

Tipped to lingual

Acute pulpitis images

Middle distal canal

Silver point

Crown preparation

Epiphany healing

Weird anatomy

Dual Xenon

Looking for MB2

Upper molar resorption

Acute apical abcess

Finding MB2

Gingival inflammation

Irreversible pulpitis

AG BU ortho band

TF Files

using TF files

Broken bur

Warm technique

Restorative prognosis

Tooth # 20 and #30

Apical third

3 canal premolar

Severe curvature

Interesting anatomy

Chamber floor

Zirconia crown

Dycal matrix

Cracked tooth

Tooth structure loss

Multiplanar curves