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Root canal treatment and direct restoration

Tooth restoration after an endodontic treatment is a very important part of the endodontic treatment because the prognosis of treatment as a whole depends on it. Many endodontic failures come exactly from an inadequate restoration after the endodontic treatment.  The vital teeth are different  from non-vital teeth in terms of physico-chemical, structural, and biological aspect. […]

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How to evaluate the debris on flutes

The primary objective of the entire root canal treatment procedure is to eliminate microorganisms and pathogenic debris from the root canal system and to prevent its reinfection: mechanical instrumentation accompanied by irrigation could be considered as the most essential component that aids in reaching this goal. To understand if the instrumentation of the endodontic space has […]

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Endo-resto treatment. Management of confluent canals - Part II

Case evaluation before treatment In endodontic treatments of teeth with more than one canal, we must allways think about the presence of possible confluences between the canals, there are several methods for their determination. In this clinical case I will present only one among others, which is performed by inserting a gutta percha and a […]

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Does anatomy represent a limit for root canal disinfection?

From a recent Randomized clinical trial (Comparison of the Effect of Two Endodontic Irrigation Protocols on the Elimination of Bacteria from Root Canal System: A Prospective, Randomized Clinical Trial) it was demonstrated that "there was no statistical difference between irrigation methods. Each protocol resulted in a high frequency of negative cultures. This high frequency of negative […]

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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 […]

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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 […]

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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 […]

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Endodontic retreatment of a maxillary second premolar with multiple shortcomings.

Knowledge of the root canal morphology and location of canals is important in a root canal treatment. Inability to locate and treat all the canals could lead to failure of a root canal treatment. For this purpose, first of all knowing the usual anatomies of all teeth and then their variations proves to be helpful. […]

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Treatment of a C shaped canal of a mandibular second molar

Mandibular second molars are known to have a complex root canal anatomy with anastomosis, resulting in some difficulties during root canal treatment, especially for the complete debridement of organic tissues and bacteria during the shaping and cleaning process and the possibility of insuring a good 3-dimensional seal during obturation. The prevalence of such anatomy is […]

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Managing a maxillary second molar with C shaped anatomy

For a more predictable root canal treatment, a good knowledge of root canal systems, their anatomy and variations, serves a vital role. A failure to identify and manage a varied anatomy could lead to failure of successful endodontic treatment. The “C- shaped” anatomy was first described by Cooke and Cox in 1979. It is named […]

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Finding the MB2 - part 2

Finding the second buccomesial canal of the first maxillary molars called MB2 is a challenge for any dentist due to its localization and anatomy. The MB2 canal is usually located in a virtual line between the MB1 canal and the palatal canal, but its different positioning along this virtual line makes it even more difficult […]

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Management of the complex anatomy of a lower first premolar

An accurate diagnosis of the morphology of the root canal system is crucial in order to obtain a successful root canal treatment.  The prevalence  of three canals with three separate foramina in mandibular premolars is very rare like in the case that will be shown in this report: one canal leaves the pulp chamber, and […]

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