Methods (differential diagnosis, investigations, and treatment method)
the treatment started with the administration of local anesthesia using a buccal infiltration of 1.8 ml of 2% lidocaine with 1:100000 epinephrine (Daroupakhsh, Tehran, Iran). A rubber dam was placed to ensure an aseptic environment. The access cavity was prepared using a high-speed diamond round bur No. 2 (Jota AG, Rüthi, Switzerland) under continuous water spray.
The orifices were negotiated with #8 and #10 K‐files (Mani Inc., Utsunomiya, Japan). Working length was determined as 25mm by an electronic apex locator (Dempex, DEM Ltd., Barnstaple, Devon, England), which was confirmed radiographically (Figure 2.B).Root canal were chemomechanically prepared by crown‐down technique with M3 rotary files (UDG, Changzhou, China) up to size 25/04 under copious irrigation with 5.25% sodium hypochlorite and normal saline, alternately. After taking cone‐fitting confirmation radiograph (Figure 2.C), all canals were dried with sterile paper points (META, Chugbuk, South Korea) and obturated with gutta‐percha (META, Chugbuk, South Korea) and AH plus sealer (Dentsply DeTrey, Konstanz, Germany) using warm vertical technique by FastFill warm obturator (Fast Fill Obturation System, Eighteeth, china).The irrigation of root canal system process followed the protocol described in Case 1. Cavit (Cavisol, Tehran, Iran) was applied as a temporary restoration (Figure 2D) and the patient was referred to the department of prosthetics for permanent restoration.