A recipe for disaster: no pre-op x-ray and wrong access cavity
Endodontic success often depends on canal debridement, disinfection, and canal obturation. Access to the canal is one key to debridement, in fact an appropriately designed access cavity assures unobstructed straight-line access to the apical third of the root canal. The endodontic treatment of maxillary incisors, especially the lateral incisors, was reported as the last successful […]
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 […]
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 […]
Retreatment of a maxillary premolar with missed canal
Success of Endodontic therapy depends upon the triad of thorough cleaning and shaping, disinfection & adequate obturation up-to the calculated working length of the root canals. Failure to follow the protocol in any of the above steps can lead to failure of the endodontic treatment. Interpretation of a preoperative radiograph is an important step in […]
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 […]
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 […]
Challenging Endo-resto of a central incisor
A 10 yrs old female came to our office due to a trauma he had some months before. The involved tooth was a non vital immature permanent upper incisor: the intra-oral examination showed swelling and an unaesthetic restoration, while radiographic examination showed open apex with incomplete root formation. One of the main objective in case […]
Cracked tooth syndrome
Cracked tooth syndrome (CTS) is where a tooth has incompletely cracked meaning without a part of the tooth breaking off. Most of the time it is an incomplete fracture of a vital posterior tooth that occasionally extends into the pulp. CTS could be considered a type of dental trauma and also one of the possible […]
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 […]
Interactions Between Endodontics and Periodontics: Part I
Understanding the interaction between endodontics and periodontics is of crucial importance to the clinician because of the challenges frequently encountered in the assessment, diagnosis, treatment and prognosis of combined endodontic–periodontal diseases. Treatment and prognosis of endodontic–periodontal diseases vary, depending on the etiology, pathogenesis and correct recognition of each specific condition. Therefore, understanding the interrelationship between […]
Direct pulp capping
A direct pulp capping is a procedure in which a medicament is placed directly over the exposed dental pulp, with the specific aim of maintaining pulp vitality and health (Camp and Fuks, 2006; Hilton, 2009; Mente et al., 2010). Advantages of a successful direct pulp capping are numerous, including the avoidance of more extensive treatment, […]
Corono-radicular fractures: a new conservative approach
Traumatic lesions of permanent dentition have a percentage of incidence which ranges from 26-76%: the most frequent causes are falls, accidents occurred during sports or as a consequence of violent episodes. Upper incisors are the most frequently affected teeth, even if, when there are traumatic lesions of the chin, as a rebound effect, it is […]