Complexity of Root Canal System

A 36 years old female presented complaining of tenderness in her top front tooth since few weeks ago. History of moderate pain started immediately after she did composite fillings in her top front teeth couple of years ago, which lasted for few days, then turned to discomfort, until few weeks ago when it became tender. Clinically, both UR1 and UL1 having composite restorations. UR1 was negative to cold test and tender to percussion compared to UL1. Pre- operative radiograph revealed radiolucency around the apex and also mesial to the mid root of UR1 with a hallow suspecting of lateral canal. Diagnosis: UR1 with necrotic pulp and symptomatic apical periodontitis (SAP). After rubber dam isolation, access revealed of a necrotic pulp…