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Step by step management of necrotic immature tooth

Obturation and filling to the root canal system is considered the last step of pulp space treatment. Providing a 3D filling to root canal space and adapting intracanal filling material to cleaned surfaces is required for long term success of the treatment to prevent reinfection. Using MTA as an artificial barrier and apical filling material […]

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Management of iatrogenic root perforations: a case report

Iatrogenic perforation can occur during different steps of the endodontic treatment which can be challenging or compromised with this procedural mishap. The purpose of this article is to report and present the nonsurgical approach to manage root perforations, located in the pulp chamber.   Root perforation is a mechanical, iatrogenic, or pathologic communication between the […]

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Revascularization - 6 years follow up

One of the main objective in case of incomplete root formation is to re-establish the blood flow allowing the continuation of the root development. Nowadays, the revascularization technique is an alternative to the traditional apexification using calcium hydroxide for a period of time in order to induce a formation of calcified apical barrier .  Infection […]

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The Sandwich Technique: A Convenient and Predictable method for Root Perforation Repair

Root perforations are defined as communications between the root canal space and the periodontium. These communications may be caused by a pathological process (as: external or internal resorption) or as a result of an iatrogenic error (as: misdirection/improper size of the post space drill, drilling through the chamber floor or improper root canal instrumentation)1. According […]

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Mid-Root Perforation Repair : A Case Report

Endodontic perforation is an iatrogenic procedural error defined as a communication between the root canal system and the periodontal attachment apparatus through the root canal walls. This defect may occur on any  given tooth at any stage of root canal therapy, from access cavity to post space preparation.   Same day Emergency appointment of a 45 year old […]

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What a surprise!

When I started treating the tooth number 3.7, I understood from the beginning that the case was peculiar. During the emergency session a radix paramolaris was not detected and a SX rotary file created immediately an accidental stripping during orifice opening. The management of an unconventional anatomy and the repair of a iatrogenic error will […]

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MTA pulp capping in an adult

MTA has a broad field of use in endodontics thanks to its biocompatibility and its capability to harden in a moist environment. Several articles proved it to be effective as a pulp capping material, although most of the literature focuses on the pulp capping in young patients...but what happens when if do this in an […]

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MTA apical plug in second lower molar

In case of large foramen the traditional techniques with gutta-percha and cement are less efficient   in term of sealing , for this reason the use of different techniques are nowadays the gold standard when we have to face resorbed apexes , zipped apexes or big foramen 

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A complex mandibular 2nd molar

A particular clinical case . The second lower molar has been endodontically treated for an invasive caries, but during the therapy the colleague faced some problems in the mesio-buccal canal and for this reason he decided to refer the patient . From the intra-op x-ray, taken during the previous treatment , it’s evident that the […]

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Fab Lab: video tutorial of MTA Sandwich Technique

Root perforation repair has historically been a treatment with a low success rate; however, recent techniques and materials utilized in root perforation repair, have dramatically improved the prognosis of both surgical and nonsurgical procedures. Root perforation is defined as an artificial communication between the root canal system to the supporting tissues of teeth often caused by using rotary […]

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Treatment of a dens invaginatus with an apical plug of calcium silicate cement

Introduction Treatment of young permanent teeth with pulp involvement is an endodontic and restorative challenge. When pulp vitality is lost, the formation of dentin stops, resulting in a tooth with thin dentin walls that is prone to fracture. Traditionally, apexification was performed with calcium hydroxide.  It was a lengthy procedure requiring 5-20 months (1) and […]

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A simple trick for a sharp apical barrier placement

One step apexification with MTA is nowadays a widely diffused procedure, although the major problem in cases of a wide open apex is the need to limit and confine the apexification material at the apex, avoiding its extrusion into the periodontal tissue. The use of a biocompatible matrix is advisable because its placement in the […]

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