CBCT guided treatment planning and management of instrument fracture in the mesial root of a second mandibular molar
Instrument fracture can be a very frustrating complication in Endodontics. Many factors determine whether a separated instrument should be removed or not from the root canal system. The aim of this case report is to highlight the usefulness of LFOV CBCT in the treatment planning of a second lower molar with a fragment in the […]
Irrigation in Difficult Anatomical Conditions: Why IrriFlex®?
IrriFlex® has appeared on the market to change our current irrigation protocols. Its main advantages like its flexibility, its ability to reach the apical part of the root canal system adapting to any curvature, its size and its simplicity to use it have made from this needle a revolution in disinfection if compared to traditional […]
Daily Endo-Restorative
As dentists 70% of the cases that come to us daily in our clinics are routine cases., cases too often underestimated where avoidable mistakes are made, making them complex In my work I share and apply a multidisciplinary approach, dealing not only with the endodontic part but also with the restorative and in some cases […]
A recipe for disaster: no pre-op x-ray and wrong access cavity
Endodontic success often depends on canal debridement, disinfection, and canal obturation. Access to the canal is one key to debridement, in fact an appropriately designed access cavity assures unobstructed straight-line access to the apical third of the root canal. The endodontic treatment of maxillary incisors, especially the lateral incisors, was reported as the last successful […]
Management of a perforating internal inflammatory root resorption in a maxillary central incisor
Internal root resorption is an inflammatory condition that produces the destruction of hard dental tissues. For the resorptive process to take place, two conditions have to occur simultaneously. First of all, predentine layer has to be damaged and expose the mineralized structures of the tooth to the osteoclastic cells and secondly, there is a need […]
Management of a deep bifurcation in a lower first premolar by perfect file
Mandibular premolars have been considered to be the most challenging teeth to be treated endodontically, especially when they present with multiple roots or canals. Their propensities for anomalous variations, narrow mesiodistal dimensions and the ensuing narrow access to canals, lack of visibility, and bifurcations and deltas are factors that further compound the difficulty for clinicians. Preoperative […]
Retreatment of a maxillary premolar with missed canal
Success of Endodontic therapy depends upon the triad of thorough cleaning and shaping, disinfection & adequate obturation up-to the calculated working length of the root canals. Failure to follow the protocol in any of the above steps can lead to failure of the endodontic treatment. Interpretation of a preoperative radiograph is an important step in […]
Triple MTA apical plug in second lower molar with overextended guttapercha
Mineral trioxide aggregate (MTA) was developed in the 1990s as a root-end filling material and has also been recognized as promising when used to form an apical barrier because of its superior biocompatibility and ability to seal and set in the presence of blood . The use of MTA as an obturation material might ultimately […]
Modification in canal preparation for long and narrow canals of lower first molar
Molar teeth exhibit more difficulty in canal preparation, due to more complexities in their root canal system. The situation becomes more complex when the roots are long, and even more difficult if they are narrow and calcified. Many iatrogenic complications may encounter if there was not a good appraisal of the case and a systematic […]
Challenging Endo-resto of a central incisor
A 10 yrs old female came to our office due to a trauma he had some months before. The involved tooth was a non vital immature permanent upper incisor: the intra-oral examination showed swelling and an unaesthetic restoration, while radiographic examination showed open apex with incomplete root formation. One of the main objective in case […]
Cracked tooth syndrome
Cracked tooth syndrome (CTS) is where a tooth has incompletely cracked meaning without a part of the tooth breaking off. Most of the time it is an incomplete fracture of a vital posterior tooth that occasionally extends into the pulp. CTS could be considered a type of dental trauma and also one of the possible […]
A goal in the hole
The main goal of endodontic treatment is the treatment and/or prevention of peri-radicular periodontitis aiming for a long term disease-free survival. The presence of any form of communication between the pulp space and the periodontist and/or the oral cavity will lead eventually to development or recurrence of peri-radicular disease which will prevent the clinician from […]