A colleague of mine planned on #27 a simple indirect restoration (after having ectracted #28), unluckily when i tried to remove all decay, i went into pulp. Immediately, without taking the dam off, I completed to remove decayed tissue then I started scouting canals and pre flared them with gates #2,#3#4#1 with K file #10 and #15 and, at the end, I put a Ca(OH)2 medication into them.
Following appointment, after having took a radiograph, I started RCT using Protaper S1, S2 and F1. Then I finished it with Profile #20 04 taper and, then, profile #25 04 taper.
I made obturation of canals by WVC using Kerr Pulp Canal Sealer.
All steps were made under warm NaClO irrigation.
In the following visit, I started building up the core using Automatrix, sealing pulp chamber with a layer of Harvard Cement (in order to find canals easily, if necessary) and making it with light curing composite. Then I took an impression using a poliether.
In the last visit, I cemented indirect restoration with the same light curing composite used to made core and the restoration itself (for this tecnique, you have to heat composite used to cement).
Please note the use of Automatrix: with it you can put the mandrel on the distal part of tooth in the zone under the back side of clamp, this thing isn’t possible using Tofflemire bands or it is difficult using Kerr ones because their mandrels are bigger. This trick permit you to drive more apically the band on the mesial side of tooth.
Best wishes from Lake Como