Upper premolar

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Upper premolar - Courtesy ROOTS

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From: Javier Pascual
To: ROOTS
Sent: Saturday, July 17, 2010 5:19 AM
Subject: [roots] UPPER PREMOLAR BAYONET SHAPE

Chief complaint: Tooth 1.5 is sensitive with cold

Tooth 1.4
Previous endodontic treatment
Chronic apical abscess (fistula)
Obturation material seems to be overextended
Periapical radiolucent lesion

Tooth 1.5
+++ response with cold test
+++ vertical percussion

I decided to treat first 1.5. What do you think about 1.4? retreatment? retreatment+surgery? exo?

1.5 bayonet shape root.
Multiple isolation. Pre endo provisional build up with flowable resin

Initial negotiation with Senseus Profinder files (Maillefer) Working lenght determination with Root ZX.
Buccal canal treated to lenght with Protaper/Profile 04.

Gutta master cone to lenght and K #08 file in palatal canal. Canals join at WL - 4 mm
(see the mark in the cone) Lingual canal treated with Protaper/Profile 04 to WL - 4 mm (avoid stress point)

I decided to "thermafilth" it :)) with Cantatore technique

Becouse double curvature:

Unable to do proper lateral condensation
Unable to do proper WVC pluggers unable to reach more than WL - 7 mm
Unable to do proper squirt unable to reach proper penetration and then to condense guttapercha- Javier

Protaper flaring 6 yr old Empress 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 Radioluscency Lateral incisor Obturation 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