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Vital pulp therapy: 2 years follow up

The size of pulp exposure and the presence of spontaneous pain were significant criteria for treatment decisions in traditional direct pulp capping procedures. Direct pulp capping was considered viable when the pulp exposure size was 1 mm or less, and the patient did not experience spontaneous pain. Root canal treatment was routinely treatment choice in cases that did not meet these criteria. However, in light of contemporary insights from the literature, a new classification of pulp conditions has emerged. Consequently, this has led to a shift in our range of indications, predominantly favoring vital pulp treatments.

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MTA apical plug and internal bleaching for Upper Central Incisor

MTA (Mineral Trioxide Aggregate) apical plug is a technique used in endodontic treatment to create a barrier at the apex of the tooth. This innovative solution has revolutionized endodontics by providing excellent sealing ability and biocompatibility. When combined with internal tooth bleaching, the MTA apical plug technique offers an aesthetically pleasing and predictable outcome for […]

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Endodontic management of immature central incisor by apexification

Trauma or caries in young children or adolescents can cause pulp necrosis, which may arrest root development in permanent teeth. This in turn results in thin dentinal walls, wide-open apices or sometimes divergent configuration or reverse anatomy, and inadequate crown-root ratio. Treatment of necrosed permanent teeth with immature apices mainly revolves around Apexification and Regenerative […]

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Does MTA ensure a good seal?

Large apices and root canal perforations are always challenging to seal with traditional root filling materials, for many reasons like shrinkage, toxicity, inflammatory response, and sealing ability of those materials. Since it was first introduced (Torabinejad et al. 1995), MTA (Mineral Trioxide Aggregate) been widely used in many clinical applications in Endodontics. In this article, […]

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Non-surgical management of Large-Apical Lesion with Open Apex

Bacterial infection of the dental pulp may lead to periapical lesions. They are generally diagnosed either during routine dental radiographic examination or following acute pain in a tooth. Most periapical lesions (>90%) can be classified as dental granulomas, radicular cysts or abscesses. The incidence of cysts within periapical lesions varies between 6 and 55%. The […]

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Direct pulp capping with MTA: 6 years follow-up

Minimally Invasive Dentistry refers to the philosophy of preserving the maximum amount of original dental tissue through a systematic approach. In this paradigm, the fundamental principle is to minimize the removal of dental structure. Therefore, in cases where the pulp is exposed, we should prioritize vital pulp treatments rather than root canal treatments.

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MTA apical plug

MTA has several desirable properties that makes it an excellent choice for apical plug formation .  Firstly , biocompatibility to the surrounding tissues . This is crucial for achieving successful healing .  Secondly , MTA has sealing capability when properly placed and condensed , it creates a tight seal , prevent the ingress of bacteria […]

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Making apical plugs easier using a simple collagen sponge

Proper seal of the root canal system is a key factor for long term success of the endodontic treatment. In the majority of cases, the root anatomy and the apical constriction offer a reliable way to control the correct apical obturation, allowing the compaction of the obturation material and tridimensional seal. However, incomplete root formation, […]

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Management of deep root perforations

Root perforation is a challenging situation when the root canal has a pathological communication with periradicular area. Perforations can occur as an iatrogenic accident during a root canal instrumentation and is the second cause of failed endodontic treatment. In some cases complications may lead even to an extraction. Thus, successful treatment of a root perforation […]

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Management of Immature Permanent Incisors with wide open apex

A major problem associated with treating traumatized teeth with necrotic pulps and open apices, is achieving an acceptable seal in the apical area. Apexification has traditionally formed an integral part of the treatment of teeth with necrotic pulps with open apices. Apexification is defined as “a method to induce a calcific barrier across an open apex of an immature, pulplesstooth”. […]

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Root perforations: from breakdown to breakthrough

In retreatments, one of real endodontic challenges comes when disassembly is complete and what remains is a root canal system that has been perforated.  What is the critical thinking required to solve such impediment to success? In this article, I am describing the management of a root perforation using absorbable collagen membrane as an internal […]

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Retrieve and repair

As Endodontists our daily work is an adrenaline fuel because we face new challenges on a daily basis and each case requires a strategy to fix it. Strategy before any retreatment consists of reading very carefully the preoperative X-Ray, in order to explain to the patient what is the problem, prognosis ,number of visits, possibility […]

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