A deep mesial caries had caused an acute pulpitis in tooth 47. Radiographic examination also revealed a mesial caries lesion and only one root in the tooth. Only one large root canal could be seen in the radiograph in 47, whereas in 48 mesial and distal canals were seen. Mandibular block anaesthesia was applied and the mesial caries was excavated and filled with IRM temporary filling material. Pulp chamber was perforated with a high-speed diamond bur under water cooling. The rest of the pulp chamber roof was removed with a round bur. Preliminary examination of the chamber floor showed only one large root canal.

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