Clinical Case Spotlight: Efficient and Predictable Endodontics by Dr. Biraj Patel

by Dr. Biraj Patel

Fig. 1:Preoperative radiograph showing deep restoration preparation in tooth #19.

Fig. 2

• File sequence: 17.04, 20.04 and 25.04 for the mesial canals. 17.04, 20.04, 25.04 and 30.04 for the distal canal. The mid-mesial canal merged with the mesiobuccal canal (Fig. 3).
• Torque and speed: 450 RPM, 2.5 Ncm.
• Irrigation: 5.25% NaOCl between file changes to remove debris and disinfect the canal system.
• Recapitulation: Performed with a #10 K-file to maintain patency.

Fig. 3

• Enhanced flexibility: FireWire NiTi technology allows for superior flexibility, reducing the risk of ledging or transportation.
• Reduced shape memory: Maintains the natural curvature of the canal, preserving anatomy and minimizing procedural errors.
• Improved cyclic fatigue resistance: Enhances durability, lowering the risk of file separation.

• 17% EDTA for one minute to remove the smear layer.
• 5.25% NaOCl for disinfection.
• A saline flush to neutralize.

• A master gutta-percha cone (matching the final file size) was tried in, with radiographic confirmation of length (Fig. 4).
• The cones were sterilized for one minute in 5.25% NaOCl and then dried.
• EdgeBioCeramic sealer was placed in the canals, followed by gutta-percha cones to working length (Fig. 5).
• The gutta-percha was cut at the orifice using an EdgePack-heated WP4004 tip plugger (Figs. 6 and 7).

Fig.4: Cone fit radiograph.

Fig.5

Fig.6

Fig.7: EdgePack

• Biocompatibility: Promotes a favorable tissue response and reduces postoperative inflammation.
• Superior sealing ability: Net expansion on setting and hydrophilic properties ensure tight adaptation to dentinal walls, minimizing microleakage.
• Antimicrobial properties: High pH contributes to bacterial elimination, reducing the risk of reinfection.
• Bioactivity: Encourages hydroxyapatite formation, supporting periapical healing and regeneration.

Fig.8

Fig.9: Postoperative radiograph demonstrating well-obturated canals with EdgeBioCeramic Sealer and final composite build-up.

Fig. 10: Root canal treatment of #30.

Fig. 11: EdgeFile X7.

Fig. 12: EdgeBioCeramic Sealer.

Dr. Biraj Patel is a board-certified endodontist with specialist training from the University of Texas. He practices at the Harley Street Centre for Endodontics in London. As a global lecturer and researcher, he focuses on microsurgery, pain management and endodontic advancements.