Case 18: Endodontic with Rebuilding the Missing Wall on Premolar

Assalammualaikum Wr Wb.. Good Morning!!

Hi.. good evening for you who read this on the evening, and good afternoon for you who read this on the afternoon.. some of you might come from across my country, Indonesia, and thanks for reading my website SekilasKonservasiGigi.Com. A mini series case report update on conservative dentistry from my daily dental practice, it should be updated each week per case, and you can also follow me on my instagram of facebook account by clicking those words. 🙂

today, I am gonna share about an endodontic case, on premolar with missing a distal wall due to caries involvement in proximal area. the focus on this case will be a creation of distal wall as a pre-endodontic restoration prior to do a good endodontic treatment. this case was done in first visit, the secret lies on the irrigating system. I used a lot of Sodium Hypoclhorite 5,25% and agitated it inside root canals while doing preparation. here it is..

dokter gigi rio suryantoro spesialis konservasi gigi perawatan saluran akar

Picture Information:

1. first view at upper left second premolar, the caries has progressed into the pulp, tooth was necrosis, positive on percussion test but no for palpation test.

2. radiographic image showed the tissue’s involvement from the loss of tooth structures and also bone structures in periapical area.

3. due to the loss of distal wall, I re-built up this area with composite resin, the matrix I used was palodent plus.

4. cleaning and shaping on buccal root canal.

5. cleaning and shaping on lingual root canal.

6. cleaning and shaping completed.

7.  finished root canal obturation with gutta percha. I filled up to 5 mm inside orifices, then filled up the cavity with SDR (smart dentin replacement) a low shrinkage stress flowable composite material.

8. SDR filled up as coronal seal up to half of crown.

9. radiographic image showed us the result of my endodontic treatment.


I did a root canal preparation with 2 different system. the buccal root canal was using protaper (Dentsply) and the lingual root canal was using M-two (VDW), both are in D0 of 30 with respective tapering from each file. then, I continued to seal the coronal area which lies in orifices with with low shrinkage stress flowable composite material (SDR, Dentsply). in order to rebuild up the missing distal wall, I used palodent plus sectional matrix (DENTSPLY). the time lapse was 30 minutes including a polishing and finishing time.

Yup, that’s for my 18th story in SekilasKonservasiGigi.Com, For more stories please visit CeritaPasienRio.Com or browse my fb at and don’t forget to click the follow botton on your rigth side to get the latest updates from my site.. see you on my next dental story..

thank You Very Much,

keep UP the GOOD WORK!!

keep on Sharing,

with love from Jakarta, Indonesia

Wassalammualaikum Wr Wb..

-drg. Rio Suryantoro, Sp.KG-

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About Rio Suryantoro, drg., Sp.KG

Dentist, conservative dentistry specialist (Restorative Dentisty and Endodontist)|case reports' author on and|trainer of conservative dentistry | live in Jakarta.
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