u/alimansurali

Do the best of what you can do and leave the rest for god

Upper 1st premolar is not always a two canal tooth some times it can be molarized so pay good attention to the pre-work radiograph

Usually when I treat lower 3rd molars I always double check for presence of accessory anatomy because this tooth is deceitful

This demo contains all the steps from access cavity preparation to the negotiation passing through glidepath and finishing with mechanical preparation, I hope this would be helpful

When treating long curved tight canals that are difficult to reach you always need to use very flexible files and increase in size gradually and slowly and limit your work to taper 0.4 files

If the end of the root has a round circular appearance we should expect that the root is curved in bucco-lingual direction so following the SLOB technique we can see the true curve by taking sever mesial and distal shifts

Treating this case was a real challenge for me

One method of permanently obturating open apex permanent necrotic teeth is apexification

Yes you can do apical plug with MTA then fill the rest of the canal with guttapercha and sealer

But it is better to obturate the canal fully with MTA

One may ask, how did you manage to limit the obturation to the root walls without extrusion to the periradicular are

The answer is easy, use resorbable sponge and push it beyond the root end to create temporary closure of the root end and to limit your materials to the root space

About 30% of lower premolar cases contains multiple canals or root so never consider it a single canal case before confirming it with radiographs

Upper 1st molars usually have mb2 canal, but if you want to make sure if mb1 and mb2 are meeting or not you need to take two Radigraphic shifts one mesial and one distal