One of the causes of endodontic treatment failure is calcification in the canal pathway, which prevents complete access to proper working length. In some cases, the dentist is unable to open the calcified canal and an extraction might be suggested then. Therefore, once calcified canals are identified, the clinician should keep in mind the following […]
Retreatment is considered a difficult manipulation that requires the knowledge, experience and technical equipment from the doctor. Resorcinol-formaldehyde therapy is no longer used as a medical material, but since the 1960s it was widely used in different countries, which increases the chance of such a patient getting into your daily practice. The article discusses the clinical scenarios developed because of the use of the mentioned material and ways to deal with it.
Before performing any root canal treatments you should have knowledge on how to face any problems you face during treatment. In this case we switched treatment plan in the middle of the case due to uncontrolled inflammation in this tooth. Diagnosis is the very first step of any endodontic treatment. To diagnose the degree of […]
Dens evaginatus (DE) is a relatively rare developmental anomaly that occurs more often in people of Asian descent than European descent. DE appears as a cusplike elevation of enamel, referred to as a tubercle, and is located in the central groove or on the buccal or lingual cusps of premolars or molars and the palatal […]
Ergonomics in dentist refers to designing tools, equipment, and workspaces to reduce health risks for operators and patients while improving posture and movement and optimizing the results for the patients.an ergonomic way. Choosing the optimal restoration for a root filled tooth requires consideration of a number of interrelated factors. When deciding on the most appropriate […]
One of the most common causes of failure in endodontics is missing canals. The middle canal in lower molars is not an exception and has been studied by numerous authors in the literature. Its prevalence ranges from 0,28% to 53,8% and it’s specially presents in the mesial root. Using different X-ray angulations or with the help of CBCT we can confirm its existence. Understanding the anatomy of the teeth is a key factor for the success of our treatment. In this case we are treating a previously treated lower molar with some hidden anatomy.
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 […]
Endodontic treatment is the most common procedures that performed in daily clinic routine the aim of endodontic therapy is to treat the infectious situation caused by bacteria from carious lesion which reached to the pulp chamber causing necrosis and lesion formation. Since pulp is the most important part of the tooth, in this article we […]
In this article, we are going to explain the Braiding Technique, a predictable way to remove materials from inside root canals. For this technique, we will use Hedstroem files, and is especially indicated to remove plastic carriers during retreatments. We will see the technical procedure and some clinical cases with video, picture and X-ray. As […]
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, […]
Perforation (often of the floor) is one of the problem to solve that can happen when we start to do a retreatment. There is a lot of confusion and question when we spoke about the management and the phases to solve this type of problem. In this article I am describing all the phases step […]
A thorough knowledge of the root canal anatomy and its variations is required for achieving success in root canal therapy, along with diagnosis, treatment planning and clinical expertise, One such variation of the root canal system is the C-shaped canal configuration. It is termed so because of the C-shaped cross-sectional anatomical configuration of the root […]
The presence of 3 rooted premolars called, little molars, is pretty infrequent. Found in only 1-4% of cases with regional variation. The two morphological types involve either two buccal and one palatal root or two palatal and one buccal root. Managing these cases is demanding due to the rarity and challenges in diagnosis, access, instrumentation, […]
A thorough knowledge of root canal anatomy is essential for predictable and successful outcomes of endodontic therapy. Mandibular premolars are rightly called “endodontist’s enigma” by Slowey, as they are known to exhibit a high degree of variability in their root canal morphology, as compared to other teeth in the oral cavity. These anatomical variations could […]
The presence or absence of periradicular disease is determined according to clinical and radiographic findings. This article will discuss the non surgical endodontic retreatment of a mandibular first molar with mid-mesial canal. Endodontic retreatment is a procedure performed on a tooth that have a previous attempt of definitive treatment resulting in a condition that […]
Speaking of ANATOMIC VARIATIONS The clinician should be aware of root canal anatomy and morphology, not to mention the protocol of debridement, disinfection and obturation. Vertucci5 reported the incidence of one canal at the apex in them at 75%, and two canals at apex at 24%. In the same study, Vertucci5 found maxillary second premolars […]
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 […]
Anatomy is one of the biggest challenges in the root canal treatment. During the step of shaping lots of errors may happen like zipping, ledges, transportation, straightening the anatomy and file separation: that’s why in this article we are going to share safe and predictable techniques for instrumenting the root canal system in several types of […]
There have been many recent technical advances in modern endodontics that have the potential to affect treatment outcomes. The purpose of this article is to determine the success of nonsurgical root canal retreatment in molars using contemporary endodontic techniques.
Straight simple root canals are rare in the human dentition; the majority present with complexities and curvatures in different planes, making the endodontic treatment a complex task that requires adaptation according to each specific case (1). One of these special anatomies is the S-shaped root canal. The purpose of this paper is to present 2 […]
Apical periodontitis serves an essential protective function aimed at confining bacteria discharged from the root canal space and preventing them from spreading into adjacent bone marrow spaces and other remote sites. The process is unique in the sense that it cannot eradicate the source of infection. The reason is that once a pulp has become […]
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”. […]
Endodontic management of a tooth is an interesting and challenging procedure that is partly blinded, and its success depends on individual clinical expertise and skill, as well as the procedural techniques applied. Tooth anatomy is the map on which every clinician relies upon prior to initiating root canal treatment. The vast data on tooth anatomy […]
The curved and dilacerated roots in the posterior teeth often present the major challenge to the clinicians during the endodontic treatments. Failure to secure a safe glide path in order to achieve an optimum biomechanical preparation may lead to complications which will jeopardize the final outcome of the treatment due to : Planning should start […]
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 […]
EIAE (Endodontic interappointment emergencies) is a complication commences a few hours or days after root canal procedures and it is characterized by the development of pain and/or swelling. Despite the advances in the endodontic field, the inter-appointment flare up remains a true nightmare that encounters every dentist. This article will report a case of inter-appointment […]
One of the main objectives in endodontic treatment is the disinfection of the root canal system. However, most of the time we face severely destroyed teeth, which means a challenge for clinicians from the absolute isolation, the selection of the clamp, the isolation technique, etc. Therefore, we must know or resolve these situations with the […]
Endodontic treatment entails thorough chemo-mechanical debridement and disinfection of the pulp spaces, followed by placement of an inert biocompatible material to allow hermetic sealing of the root canal system. Inability to meet either of these objectives can inadvertently lead to endodontic failure. Concomitantly, an awareness of normal and aberrant root canal morphology is a key […]
Understanding the anatomical variations of the root canal system is a must to achieve the main goals of our treatment. The radix entomolaris is the most common variation in mandibular molars. With the help of CBCT we can measure and see the original shape of the additional root, thus creating a predictable strategy for cleaning, […]
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 […]
Failure to locate and disinfect all the root canals may be a major reason for endodontic failure. The first Step to reach the success of root canal therapy is to have a good knowledge of the root canal morphology in order to get a successful Root Canal Treatment Slowey has suggested that mandibular first premolars , often […]
An endodontic access cavity is an important first step in successful endodontic treatment. Lately, strongly constricted endodontic access cavities have become quite popular, the idea of which serves to save tissue and thereby increase the tooth's resistance to fracture. Although there is insufficient data to fully support this hypothesis (1), many different modalities have an […]
A case presentation of hemisectioning of the distal root of a LR6 due to fracture, and 6-year review. The clinical aspects and considerations are discussed. Occasionally, during our practice, we are required to offer patients a less common treatment modality. Knowing all the possible treatment options available to us, we can provide our patients with […]
The ledge, which is a deviation from the original canal curvature without communication with the periodontal ligament, is created when the working length can no longer be negotiated, and the original pathway of the canal has been lost. Ledge formation might lead to incomplete instrumentation and shaping, inadequate disinfection, and inadequate three-dimensional obturation of the root canal […]
The discoloration of a dental element can create a strong aesthetic discomfort and can often be the first clinical sign of an ongoing pulp disease. The causes of dyschromias are many and, as always, a correct diagnosis is the cornerstone of solving the problem. The causes that can lead to a chromatic variation of a […]
This article clarifies how to deal with extra root canal system anatomy of premolars clinically and how you can manage and shape the buccal tinny and curved canals of molarized premolar with simple technique by using an handpiece with manual files in reciprocation motion. Endodontic treatment success is dependent on thorough debridement and full obturation […]
The root canal treatment of immature permanent teeth poses many challenges, one of which is the obturation technique. These teeth come with wide apices and sometimes even a divergent configuration (or reverse anatomy) in the apical third. The difficulty in such cases is to avoid overextending the filling material into the periapical tissues. (1,2) In […]
The danger zone is an area of the root canal where the primary thickness of dentin before preparation is under 1 mm. In general, the danger zone is located 4 to 6 mm below the canal chamber orifice. A danger zone can appear in the buccal root of maxillary premolars and molars and in the […]
Ergonomics in endodontics refers to designing tools, equipment, and workspaces to reduce health risks for operators and patients while improving posture and movement. Ergonomics in endodontics is extremely important to ensure effective and safe execution of the treatment. It refers to the design of tools, equipment and workspaces in order to minimize risks to the […]
