Two palatal cusps and some weird anatomy

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Two palatal cusps and some weird anatomy - Courtesy ROOTS

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From: Javier Pascual
To: ROOTS
Sent: Wednesday, July 29, 2009 12:29 AM
Subject: [roots] Upper first molar with weird anatomy

Two palatal cusps and some weird anatomy in the preop x-ray...

Pulp Diagnosis: Necrosis. Periapical Diagnosis: Symptomatic Apical Peridontitis. Canal dressing for four weeks
with CaOH. Instrumentation with hybrid technique Protaper/Profile. Gutta with resin based sealer. Warm vertical
condensation. Pulp floor sealed with flowable composite.

Preop build up with flowable resin, as you may see I have serious problems to do a proper contact point :((
GP will be able to do a proper wall much more better than me.

Toughest root canal Retricted mouth opening Deep decay Upper second molar Open sinus lift Implant after extraction Implant # 20 Implant # 30 Irreversible pulpitis 2 step necrotic case Fracture Lesion on MB Endo perio case Surgery or implant Silver point removal	Series of cases SS reamers and files Single visit RCT Ortho resorption Apico retreatment Apical perforation Funky canine Crown preparation Two tough molars Epiphany recall To squirt or not Core distal end MTA miracles Pain with LR Instrument removal	3 canals upper Bi Acute pain Dental decay Calcified chamber Mandibular first molar Ultrasonic activation Fluorosis TF and patency Interim dressing Huge lesion Tough distal canal Debris in pulp chamber Access and success Restricted mouth opening Broken drill fragment	MB2 or lateral Gutta percha cases Another calcified Big Perf Canals and exit Dam abuse Amalgam replacement Simple MTA case MTA barrier Restoration with simile Immediate implant Traumatic accident Lesion on D root Extract / Implant Carious exposure