Figure First molar on the left side of the mandible: A) initial radiograph, extensive distal caries, PDL widening, S-shaped canals; B) working length determining; C) final radiograph, obturation, apical seal, temporary restoration; D) 18-month follow-up, coronal seal

A healthy 10-year-old girl with spontaneous pain in the right mandibular first molars was referred to the endodontics department. The sensitivity test to heat and cold was negative and only unstimulated. Initial radiography revealed (Figure 2A), radix entomolaris, and double curvature with the bull’s eye view. Clinical and radiography examinations showed signs of irreversible pulpitis. The access cavity was obtained according to the mesial caries and extra RE root. Each canal’s shaping, instrumentation, irrigation, and obturation were done according to the treatment protocol described in the first case (Figures 2). A follow-up visit was performed 8 months later and he reported no pain in the two treated teeth. Clinical examination and radiography also showed an asymptomatic tooth with successful endodontic treatment (Figure 2E ) <Figures 2 >.