The main difficulty in the case was the dilacerations in the apical 3 mm of all canals. To be able to fully instrument and clean the canal system, I started with proper access. I used the Edge Endo 25/.08 gutta remover file as an orifice opener . I negotiated the middle portions of the canals with #'s 8 and 10 files and irrigated with 10% Citric acid. I then started carefully negotiating the apical thirds with #6 FlexoFiles, followed by #8, 10 and 12. At this point, I switched to NaOCl and started using .02 tapered rotary files to create a better glide path. I started crown down with EdgeFiles #30/04, #25/04 and #20/04. Canal preparation was completed by dropping in a 20/06 in the D canal to full length but shy of full length in the mesial canals. Obturation was completed by warm vertical compaction of a cone in the D canal and by "squirting" or syringing/compacting warm gutta percha into the mesial canals. I restored the access with CoreFlo DC (BISCO) and Heliomolar resins.
FILES and PRODUCTS USEDFlexoFiles #6-12, Dentsply PathFiles #13,17, 19; EdgeFiles #30/04, 25/04, 20/04 and 20/06; 10% citric acid followed by full strength (8%) NaOCl. Kerr EWT zinc oxide eugenol sealer, Charles Schwed Nano flow gutta percha point and B&L Biotech Beta gun with regular flow gutta percha.