A graduate of the University of Illinois-Chicago (UIC) College of Dentistry, Dr. Johnson completed the Dentist-in-Residence Program and a UIC College of Medicine Residency before being appointed Assistant Clinical Professor at UIC College of Medicine. He received a certificate of Orthodontics and Dental Orthopedics from the USDI, was awarded the Academy of General Dentistry Fellowship and Mastership, and is Board Eligible in General Dentistry. An international lecturer and published author, Dr. Johnson has advised elected officials on oral healthcare at the federal, state, and local levels and is currently in private practice in suburban Chicago.
A bioactive and highly flowable mineral root canal sealer, BioRoot Flow is based on Septodont’s patented Active Biosilicate Technology (ABS), which is composed of calcium carbonate, zirconium oxide, and tricalcium silicate, among other components. Compared to mineral trioxide aggregate (MTA)—which also contains tricalcium silicate and has been available for over 20 years for retrograde apical fillings, repairing root perforations, pulp capping, and repairing internal root resorption—BioRoot Flow has a unique, pure formula with a premixed highly flowable composition, and ready-to-use syringe dispensing. Designed for cold and warm techniques, BioRoot Flow made obturation easy during the following root canal procedure. In my opinion, BioRoot Flow is truly a next generation endodontic material.
An 88-year-old man presented with spontaneous, lingering, and radiating mandibular sharp pain elicited by cold that radiated to the distal to tooth No. 31. Electric pulp testing evoked discomfort at setting 1. Occlusion was within normal limits (Figure 1). The patient was diagnosed with symptomatic irreversible pulpitis. A periapical preoperative x-ray was taken (Figure 2).
Preparing for Root Canal Therapy
The patient elected root canal therapy for tooth No. 27 and declined the use of a rubber dam and clamp. Two carpules of 2% Lidocaine with 1:100,000 epinephrine were injected as a mandibular block and a long buccal injection.
Access through the incisal edge composite was made. An electronic apex locator determined a working length with a No. 25 file at 27 mm. The canal was hand and rotary filed with NiTi files to 27 mm with sodium hypochlorite and liquid EDTA irrigants. The Crown-Down technique was utilized in filing. After filing was completed, the canal was copiously irrigated with sterile saline to remove all other irrigants and debris (Figure 3). Paper points were used to dry the canal.
