Electric pulp testing (EPT) gave no response, and a small periapical lesion could be seen in the pre-operative radiograph. A diagnosis was therefore chronic apical periodontitis (CAP) and the treatment plan was treatment of a necrotic tooth.
The root canal was perforated with a high speed diamond bur and the canal localized. Rubber dam was placed and the working field disinfected with chlorhexidine-ethanol solution. A size #25 Flexoreamer was inserted into the canal and the working length was determined to 21 mm by using an electronic apex locator and a working length radiograph.