Root canal treatment (RCT) is a highly predictable procedure for saving teeth affected by deep caries and pulp inflammation. In this detailed clinical case, Dr. Haider Ali from Pakistan successfully performed a single-visit root canal treatment on a young patient. This intermediate difficulty case demonstrates modern endodontic techniques using advanced Rogin rotary files and irrigation systems.
This article is inspired by Dr. Haider Aliโs clinical demonstration, showcasing efficient diagnosis, instrumentation, and obturation in one appointment.
Patient Details and Initial Complaint
A 23-year-old female patient presented with pain in the left lower jaw. The discomfort was previously aggravated by chewing and exposure to hot and cold foods or drinks. These symptoms are typical of pulpal inflammation and often indicate the need for prompt endodontic intervention.
Clinical and Radiographic Findings
Clinical examination identified a Class I carious lesion on the mandibular first molar (tooth #46).
Key diagnostic tests included:
- Cold test: Positive with lingering response
- Tooth Tender to Percussion (TTP): Positive
- Periodontal probing: Average depths of 2-3 mm, indicating good periodontal health
Intraoral Periapical (IOPA) radiograph revealed caries extending into the pulp chamber, confirming the need for root canal therapy.
Final Diagnosis
- Pulpal Diagnosis: Symptomatic Irreversible Pulpitis
- Apical Diagnosis: Symptomatic Apical Periodontitis
These diagnoses support root canal treatment as the treatment of choice to remove the inflamed pulp and seal the canal system.
Treatment: Efficient Single-Visit Root Canal Procedure
Dr. Haider Ali completed the entire root canal treatment in a single visit after achieving patency and controlling bleeding. Single-visit RCT offers advantages such as reduced patient appointments, immediate coronal sealing, and high success rates when proper disinfection is achieved.
Detailed Clinical Workflow
- Diagnosis Confirmation: Positive cold test and TTP, supported by radiographic evidence of caries reaching the pulp.
- Access Cavity and Patency: Straight-line access was prepared, and patency was successfully achieved.
- Glide Path Creation: A reliable glide path was established using Rogin R-Shaper.
- Canal Instrumentation: Cleaning and shaping performed with Rogin Sub Taper Blue rotary files up to F2.
- Irrigation and Activation: Comprehensive irrigation protocol using:
- 5% NaOCl
- Saline
- 17% EDTA All irrigants were activated with Rogin Ultra Max ultrasonic device for superior debris removal and disinfection.
- Obturation: Three-dimensional obturation completed using Rogin EliteFill G (gutta-percha) and EliteFill P (sealer).
- Coronal Restoration: Immediate composite core build-up to restore the tooth structure.
Clinical Tips from the Case (Highlighted in the Demonstration)
- Positive Cold Test + TTP reliably confirms symptomatic irreversible pulpitis with apical involvement.
- Single-visit RCT is highly feasible when early patency is achieved and the canal system can be thoroughly cleaned in one appointment.
- Ultrasonic activation of irrigants (via Rogin Ultra Max) enhances the effectiveness of disinfection, which is critical in single-visit protocols.
The use of Rogin rotary files provided excellent flexibility, cutting efficiency, and safety throughout the procedure.
Benefits of Modern Single-Visit Endodontics
This case highlights how contemporary tools like Rogin R-Shaper, Sub Taper Blue, and Ultra Max allow clinicians to deliver predictable results efficiently. Patients benefit from fewer visits, faster relief from pain, and preservation of their natural tooth.
Root canal treatment on posterior teeth like the mandibular first molar requires precision due to complex anatomy, but with proper technique and materials, success rates remain very high.
