One of the challenges of Endodontics is the location of root canals, so that they can be cleaned, reshaped and filled properly. The use of ultrasound and visualization of the operative field under magnification has increased safety in certain endodontic treatments, ensuring optimal results. The objective of this study was to show a clinical approach of treating a tooth with calcification at the opening of canals where access to the pulp chamber was performed, followed by removal of calcification and location of canals under magnification using ultrasonic inserts. The case was finished with definitive crown-root sealing in a single session. It can be concluded that the associated use of ultrasound under magnification is a feasible clinical strategy to access areas of calcification.

Background: Mineral trioxide aggregate (MTA) has been used in a variety of surgical and non-surgical endodontic applications. The aim of this study was to evaluate the gene expression and protein production of TNF-a, IL-1b and IL-6, as well as the gene expression of RANKL and OPG using both commercial and experimental MTA in macrophage cell cultures. Methods: Peritoneal macrophage cell culture was performed. Viability, gene expression of cytokines, RANKL and OPG, and protein levels in experimental-and commercial-grey MTA co-cultured with peritoneal macrophages was determined by tryptan blue, real time PCR and ELISA. Results: The expression of TNF-a for both commercial and experimental MTA was higher, while the expression of IL-1b and IL-6 was similar when compared to the negative control. At protein expression level, no differences were observed between the negative control and cements. RANKL did not show a significant improvement in gene expression when compared with the negative control, but OPG expression in cement samples was higher when compared to the negative control. Conclusions: This study suggests that commercial and experimental MTA promotes anti-inflammatory processes, as well as bone healing capacity.