07/01/2024
**Title: "Optimizing Endodontic Success: A Comprehensive Case Study"**
**Introduction:**
A 35-year-old female patient sought our clinic with throbbing pain and sensitivity in a grossly carious tooth (Refer IOPA No.1). Initially reluctant for root canal treatment, she opted for medication as pain relief, returning 10 to 11 months later with a worsened condition, accompanied by gingival swelling ,you can clearly see periapical bone loss till furcation (Refer IOPA No.2).
**Challenges Faced:**
Upon deciding on root canal treatment, we encountered unexpected difficulties. While negotiating with a 15 no k file, an accidental breakage occurred in the mesio buccal canal in the apical third 15 No k file 3 to 4 mm (Refer IOPA No.2).
**Treatment Approach:**
Undeterred, we commenced the intricate process by bypassing the broken file using 10no C files, gradually progressing to 20 no, and employing rotary Neoendo files. Extensive irrigation was crucial, involving the use of 5% Hypochlorite and EDTA. Multiple 15 no k files and 10 k files were used for bypassing (Refer IOPA No.3).
The sealing process utilized Endoseal, a Eugenol-based (Endoseal) sealer. An ultrasonic activator (Woodpecker Ultra X) facilitated effective irrigation, ensuring meticulous canal preparation. Specific canal percentages were achieved: Mesio buccal (20no, 4%), Mesio lingual (25no, 4%), and Distal (20no, 6%).
**Post-treatment and Recommendations:**
Immediate obturation was performed, and a follow-up after six months showcased significant healing. I strongly recommend a detailed irrigation protocol, involving 5% Hypochlorite for a minimum of two minutes, followed by ultrasonic or sonic irrigation for one minute, and a subsequent two-minute irrigation. Additionally, liquid EDTA for one minute enhances results.
In certain cases, the application of intracanal heating with an *ENDOKING OBTURATING PLUGGER* during sod hypochlorite irrigation can elevate efficacy.
**Conclusion:**
This comprehensive case study underscores the successful management of a challenging endodontic scenario through a meticulous combination of strategic irrigation, tailored instrumentation, and adept treatment protocols. The emphasis on detailed post-treatment care and continuous evaluation remains paramount for optimal outcomes.