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The management of a buccal perforation in a lower incisor

Root perforations are characterized by a communication between the root canal system and the external tooth surface. They are caused by a pathological process or an operative procedural accident. When iatrogenic, they can occur during access cavity opening, root canal preparation or during post preparation. Root perforation needs to be diagnosed early and treated appropriately as soon as possible, since they may cause an inflammatory […]

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The management of two mandibular molars with apical inflammatory root resorption

Apical pathology can appear as a straightforward diagnosis, however the tools available for assessment come across different limitations. Histology has highlighted various aspects that can not be yet coherently linked to a clinical situation using imaging investigations (Ricucci, Mannocci & Pitt Ford, 2006). Inflammatory root resorption makes no exception and reveals itself on periapical x-ray […]

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Lower second molar: carrier based obturation...through the furcation

Perforations are defined as artificial communications between the root canal space and the surrounding tissues. Endodontic perforations represent an interruption of the continuum between the endodontic space and the periradicular tissues, periodontal tissues or oral cavity.  In the presence of perforation, studies report a 10 to 12% increase in the failure rate of endodontic procedures.  […]

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Vital Pulp Therapy: Part 1: Direct Pulp Capping for A Traumatic Exposure of Permanent Maxillary Right Central Incisor

Pulp inflammation or exposure may occur as a result of many reasons like carries, trauma, or over-zealous preparation. However, if left untreated, this may lead to pulpits, pulp necrosis, and then apical periodontitis, which means more cost and chair-time spent. In addition, more tooth structure loss would jeopardise the survival rate and the outcomes of […]

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Saving hopeless tooth: case report

With introduction of mineral trioxide aggregate and other bioactive materials in endodontics possibilities of saving compromised teeth have improved significantly.    

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Perforation repair: step by step

A tooth perforation is a pathologic or iatrogenic communication between the root canal space and the periodontal apparatus. To clinically determine if an endodontically perforated tooth should be extracted or saved, the clinician must first understand the prognosis and treatment. The biologic response of a perforated tooth is inflammatory and can cause a breakdown of […]

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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 […]

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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 […]

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Necrodontics - saving hopeless teeth

Both non-surgical and surgical retreatment procedures are performed when the primary treatment fails and we are trying to preserve the tooth. Usually the next attempt after the primary treatment is non-surgical retreatment and follow up. In some cases when we estimate that non-surgical procedures will not be helpful we can perform surgical retreatment with apicectomy.  […]

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Three Years Follow-up of Large Lesion Treated With MTA Apical Plug

The goal of Endodontic treatment is to cure or prevent apical periodontitis (Ørstavik & Pitt Ford 2008). Endodontic treatment does not end when the root canal being filled, but when having favourable outcomes of the treatment upon reviewing (Reit 1986), which can be achieved by the infection control management through the root canal procedure (Basrani […]

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Management of Iatrogenic Furcal Perforation in tooth with obliterated root canal

Perforation is a pathologic or iatrogenic communication between root canal system and the supporting tissues of teeth or the oral cavity. Root perforations are common complications of endodontic treatment or post preparation and often lead to tooth extraction. Iatrogenic root perforations occur in approximately 2‑12% of endodontically treated teeth. Successful treatment depends mainly on immediate […]

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Root perforation management

This article is a short summary and a guideline for all dentists who want to manage different types of root perforation in an easy and predictable way. This article will emphasize the importance of the diagnosis and accessories that will be helpful during the treatment.   Root perforations are one of the common complications that […]

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