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rev port estomatol med dent cir maxilofac . 2019;60(3):145-149 147

nephrine was performed for each tooth. A rubber dam was
placed, followed by access opening to the pulp chamber using
round diamond burs #1015 (KG-Sorensen, Barueri, SP, Brazil)
and a high-speed Endo-Z stainless steel bur (Dentsply/Maille-
fer, Switzerland) under cooling. An operating microscope (DF
Vasconcelos, Valencia, RJ, Brazil) was used during the access.
The wear was extended to the mesial portion, thus facilitating
the access to the second root canal of tooth 11. After the access
to both teeth was completed, the diagnosis of pulp necrosis
was visually confirmed.
The glide path was established with # 15 K-type files
(Dentsply/Maillefer, Switzerland) and the cervical third was
prepared using size 2, 3 and 4 Gates Glidden burs (Dentsply/
Maillefer, Switzerland). The working length was established at
21 mm in the distal portion and 20 mm in the mesial portion
with the aid of an electronic apex locator (Novapex , Forum
®
Technologies, Israel).
The distal and mesial root canals were then prepared using
®
the WaveOne Primary and Large files (Dentsply/Maillefer,
Switzerland), respectively. The chemical solutions used during
the preparation of the root canals were 2.5% sodium hypochlo-
rite and 17% EDTA before obturation. Final irrigation was done
with sodium hypochlorite.
The root canals were dried with WaveOne absorbent pa-
®
per points (Dentsply/Maillefer, Switzerland) and obturated
with WaveOne gutta-percha points using the hybrid ther-
mo-mechanic technique with the size 50 McSpadden ther-

Figure 2. Initial periapical radiograph

X-ray source with a 120-kVp valve voltage, a 3 to 7-mA valve
current, and a 0.5-mm focal point. The protocol Mand 6 cm, 40
sec, 0.2 voxel, MaxRes was used for image acquisition. The
examination showed the presence of two independent root
canals: one in the mesial portion and the other one in the
distal portion of the root of tooth 11 (Figure 3).
A diagnosis of pulp necrosis with asymptomatic apical
periodontitis was established for both teeth. Local anesthesia
by infiltration using 1.8 mL of 2% lidocaine with 1:100,000 epi-

Figure 3. Cone-beam computed tomography, axial section Figure 4. Final periapical radiograph