Clinical Effectiveness of Magnification in Managing Calcified Canals and Immediate Definitive Restoration: A Case Report
José Evando da Silva-Filho
*
Department of Dental Radiology and Imaging, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil and Department of Endodontics, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil.
Ana Beatriz Cardoso-Oliveira
Department of Operative Dentistry and Dental Materials, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil.
Ana Paula Caracas-de-Araújo
Department of Operative Dentistry and Dental Materials, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil.
Mariana Veras Godeiro
Department of Operative Dentistry and Dental Materials, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil.
Paula Welliana Araújo Martins
Department of Orofacial Harmonization, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil.
Danielle Frota de Albuquerque
Department of Dental Radiology and Imaging, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil and Department of Stomatology, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil.
Maria Denise Rodrigues de-Moraes
Department of Operative Dentistry and Dental Materials, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil.
Eduardo Diogo Gurgel-Filho
Department of Endodontics, Faculty of Dentistry, University of Fortaleza, 587 Dr. Valmir Pontes Avenue, Edson Queiroz, Fortaleza, Ceará, 60812-020, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Pulp canal calcification represents a significant challenge in endodontics, marked by progressive obliteration of the canal lumen that complicates localization, negotiation, and effective disinfection. This case report presents a clinical protocol applied to a maxillary molar with severe calcification in the orifice portion of the mesiobuccal canal. Using high-magnification operating microscopy and ultrasonic instrumentation, the canal orifice was successfully located and instrumented. An immediate definitive restoration was performed to optimize the coronal seal and reduce the risk of microleakage and reinfection. The treatment followed a structured, stepwise approach incorporating current technological resources and evidence-based procedures, including selective dentin removal, glide path creation, and adhesive restorative techniques. Treatment involved three clinical sessions, with initial preparation of the distobuccal and palatal canals using manual and rotary instruments, followed by location and negotiation of the calcified mesiobuccal canal using ultrasonic tips and C-Pilot files under magnification, intracanal medication with calcium hydroxide, and final obturation by lateral condensation. Restoration included hybrid adhesive protocols and cusp reconstruction to ensure long-term seal and mechanical stability. This approach allowed for preservation of tooth structure and favorable prognosis in a complex anatomical scenario. The case emphasizes the importance of clinician expertise, customized access design, and timely restoration to reduce the risk of procedural complications. It highlights the need for adaptable, case-specific strategies in managing calcified canals to support predictable outcomes and long-term clinical success.
Keywords: Case Reports, clinical protocols, dental restoration, permanent, pulp canal obliteration, ultrasonics