This paper aims to report a single-session endodontic treatment of a periapical lesion, while highlighting the effectiveness and safety of the technique. The patient presented with no painful symptoms at the clinic to have his maxillary anterior teeth examined due to trauma suffered two years earlier. Radiographic examination revealed a lesion in the apical periodontium, extending from the region of tooth #13 to tooth #23. The teeth were isolated, and access surgery was performed in all crowns. Cleaning and shaping (6% NaOCl) were carried out with Gattes-Glidden drills with step-back instrumentation from #2 to #4. Catheterization was performed with manual files #25 up to the working length (6% NaOCl), and confirmed with foramen locator. Cleaning and shaping of all root canals were performed with the aid of ProTapers F4 and F5 instruments (Dentisply/Maillefer) (6% NaOCl).Passive ultrasonic irrigation was performed for 3 minutes in each tooth with continuous irrigation of 17% EDTA and Irrisonic ultrasonic insert (Helse). Final irrigation with 6% NaOCl and drying with paper points were performed. There was placement of methylene blue at 0.05% for 5 minutes on each tooth, followed by laser application (photodynamic therapy) for 80 seconds on each tooth. New irrigation with 6% NaOCl was carried out to remove the remaining methylene blue. Drying with paper points was performed for a second time, followed by filling with gutta-percha ProTapers F5 cones thermoplasticized with gutta-percha condenser #60 and AHPlus paste. In checking the conditions two years later, it was found that the procedure had been performed with integrity, thereby confirming the success of single-session endodontic treatment of infected root canals.Keywords: Endodontics. Root canal therapy. Odontoplasty. How to cite this article: Braitt AH, Santos JL, Braitt GR, Rodrigues EA, Bueno CES. Single-session endodontic treatment of six teeth with extensive periapical lesion.

Root canal anatomy is complex, and the recognition of anatomic variations could be a challenge for clinicians. This case report describes the importance of cone beam computed tomographyic (CBCT) imaging during endodontic treatment. A 23 year old woman was referred by her general dental practitioner with the chief complaint of spontaneous pain in her right posterior maxilla. From the clinical and radiographic findings, a diagnosis of symptomatic irreversible pulpitis was made and endodontic treatment was suggested to the patient. The patient underwent CBCT examination, and CBCT scan slices revealed seven canals: three mesiobuccal (MB1, MB2, and MB3), two distobuccal (DB1 and DB2), and two palatal (P1 and P2). Canals were successfully treated with reciprocating files and filled using single-cone filling technique. Precise knowledge of root canal morphology and its variation is important during root canal treatment. CBCT examination is an excellent tool for identifying and managing these complex root canal systems.

Introduction: Since periapical surgical therapy success depends on adequate apical seal, MTA has been recommended as the best retrofilling material.Objective: To assess whether the association between MTA and Fillapex sealer negatively affects the material apical sealing ability. To this end, apical leakage was tested with 1% rhodamine B was used. Methods: Fifty roots with straight canals were prepared by means of the ProTaper Universal system up to F5 instrument, and filled by means of the modified McSpaden technique. Specimens were divided into four groups: G1, G2 and G3 were subjected to apicoectomy and retropreparation with ultrasonic tip; whereas G4 did not undergo either apicoectomy nor retropreparation, and served as control.G1 was retrofilled with MTA-water, G2 was retrofilled with MTA-Fillapex, and G3 was not retrofilled, thereby serving as negative control. The roots of G4 received two coats of red nail polish, whereas the roots of G1, G2 and G3 were also coated, except in the region where apicoectomy was carried out. Specimens were immersed in 3 ml of 1% rhodamine B for 8 days and stored in an incubator at 37 °C and 100% humidity. In order to have microleakage assessed, the specimens were longitudinally cleaved, photographed and sent to three specialists in Endodontics who analyzed four levels of leakage: zero; 0-1 mm, 1-2 mm and 2-3 mm. Results: Results reveal that the MTA-Fillapex association had less leakage than MTA-water.

Introduction: The purpose of endodontic instrumentation is to promote cleaning and shaping of the root canal, preparing it for final filling. Objective: The objective of this study was to evaluate, in vitro, the cleaning quality of simulated canal blocks instrumented by two nickel-titanium rotary systems. Methods: Twenty acrylic blocks (simulated canals) were used and separated into two groups of ten each. India ink was injected into the simulated canals which were wrapped up with foil to avoid influencing during instrumentation. The blocks in Group 1 were instrumented by means of the original sequence of ProTaper Universal system up to file F3. 5 ml of saline solution were used for irrigation at each change of instrument. The blocks of Group 2 were instrumented by heat-treated ProDesign S system up to file #30.05; 5ml of saline solution were also used for irrigation. After instrumentation, the blocks were photographed and analyzed in terms of cleanliness by three Masters in Endodontics. Conclusion: Within the experimental conditions of this research, it was reasonable to conclude that no statistical differences were found between the cleaning ability of both systems studied.

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