Abstract:
This case report presents the endodontic management of a maxillary first molar presenting with acute pain on biting and thermal sensitivity. Clinical and radiographic evaluation revealed recurrent caries beneath an existing composite restoration on the mesial surface, leading to a diagnosis of irreversible pulpitis. Root canal treatment was performed using Rogin Super Flexi Files for canal preparation. The files demonstrated excellent flexibility and cutting efficiency, particularly in managing complex root anatomy. The case highlights the importance of proper diagnosis, meticulous treatment planning, and the selection of high-performance instruments such as Rogin Super Flexi Files in achieving successful endodontic outcomes.
Introduction
Patients often present with post-restorative pain that may escalate into acute symptoms requiring endodontic intervention. This report details the management of a first upper molar with severe pain following composite restoration. The treatment was performed using Rogin Super Flexi Files, renowned for their flexibility and durability, particularly in curved canals.
Patient History and Clinical Examination
A male patient presented to the clinic in the evening with intense pain that prevented him from sleeping. He reported severe discomfort upon biting and sensitivity to hot liquids. Clinical examination revealed a previously restored maxillary first molar (tooth #16) with tenderness on percussion. Radiographic imaging showed recurrent caries beneath the old mesial composite restoration.
Diagnosis and Treatment Planning
Based on clinical and radiographic findings, a diagnosis of irreversible pulpitis was established. Non-surgical root canal therapy was deemed the most appropriate treatment option.
First Visit Procedure
The treatment was performed over two visits, each lasting approximately 90 minutes.
* The old composite restoration was removed, and an access cavity was prepared.
* Upon accessing the pulp chamber, profuse bleeding was observed, consistent with vital inflamed pulp tissue.
Scouting and Initial Instrumentation
* Scouting was initiated using a size 10 K-file.
* Preflaring was performed using Rogin Super Flexi Orifice Opener, which enabled smoother file navigation and reduced instrument stress during canal preparation.
Canal Anatomy and Working Length Determination
* The tooth exhibited three roots and four canals (MB1, MB2, DB, and P), with MB1 and MB2 merging into a single exit.
* Working length was determined using Rogin Apex Locator in conjunction with K-files.
Cleaning and Shaping
* Manual enlargement to size 20 K-file was performed to establish a glide path.
* Rotary instrumentation was completed using Rogin Super Flexi Files:
* Mesio-buccal and disto-buccal canals were prepared to size 25, taper .04
* Palatal canal was prepared to size 30, taper .04
Irrigation Protocol
* Each canal was irrigated with 5.25% sodium hypochlorite using 3 syringes per canal.
* Irrigant activation was carried out using both sonic and ultrasonic agitation to enhance disinfection.
Obturation
* Canals were obturated using the warm vertical compaction (WVC) technique, ensuring a dense and well-adapted fill.
Discussion
The successful management of this case was significantly supported by the use of Rogin Super Flexi Files. Their superior flexibility minimized the risk of canal transportation and maintained the original canal curvature, particularly in the mesiobuccal system. The cutting efficiency of the files facilitated rapid and precise shaping, enhancing overall procedural efficiency.
Key Advantages of Rogin Super Flexi Files:
* High flexibility, allowing safe navigation in curved or complex canals
* Efficient cutting performance, reducing preparation time
* Durability, with the capability of preparing more than 25 canals per file
* Enhanced control, especially beneficial for clinicians at varying experience levels
Conclusion
Accurate diagnosis and individualized treatment planning are critical components of successful endodontic therapy. The use of Rogin Super Flexi Files in this case allowed for efficient and safe canal preparation, preserving canal anatomy while ensuring effective cleaning and shaping. These files are a valuable asset in managing challenging cases, particularly those involving curved or narrow canals.
