Apical Control in Primary Root Canal Treatment of the Lower Right Second Molar (LR7)

Patient Presentation & Chief Complaint A patient presented to the clinic reporting spontaneous, lingering pain in the lower right posterior region, exacerbated by thermal stimuli. Clinical examination of the lower right second molar (LR7 / FDI 47) revealed deep carious involvement, tenderness to percussion, and an absence of a healthy periapical complex on initial radiographic assessment. A diagnosis of symptomatic irreversible pulpitis with symptomatic apical periodontitis was established, and primary root canal treatment with emphasis on apical control was planned. Pre-operative periapical radiograph of LR7 demonstrating deep carious involvement and early periapical rarefaction. Pre-operative clinical view showing the extent of coronal destruction prior to access cavity preparation. CBCT Assessment & Treatment Planning Cone-beam computed tomography (CBCT) was obtained to accurately…