Endodontic treatment of tooth 18 bearing a cast metal crown – case report

Abstract

This study described the root canal preparation of a maxillary third molar with a cast metal crown. A 59-year-old male patient, with no history of systemic diseases, sought private consultation, complaining of pain to cold that did not relieve with analgesics or anti-inflammatory drugs. Radiography revealed a cast metal crown and atresic canals. After anesthesia, the coronal opening was performed with a transmetal bur, with the aid of an operating microscope. Electronic odontometry was performed with a foraminal locator, Root Zx Mini Apex Locator (J. Morita Corp., USA), taking care not to touch the metal part, avoiding errors in the locator reading. The preparation was done with 35.06 mm in the buccal canals (Wave One Gold Medium) and 45.05 mm in the palatal canal (Save One Gold Large). Sodium hypochlorite at 2.5% was used as irrigating solution. Obturation of the root canal system was performed using the single cone technique. It is concluded that endodontic access in prosthetic crowns presents greater difficulty when compared to access in natural teeth; however, taking the necessary precautions to preserve the integrity of the dentin structure as much as possible is possible.