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Step by step management of necrotic immature tooth
MTA Obturation

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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Last check of the working length
Tips and tricks Uncategorized

Working lenght (WL) is a controversial topic in Endodontics but, fortunately, Clinicians and Authors agree about respecting it as much is possible during the entire endodontic treatment.  WL is the distance from a coronal reference point to the point at which canal preparation and filling should terminate. The respect of an accurate WL determination during […]

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Invasive Cervical Resorption Part1: Conservative Non-surgical management
CBCT Decision making micro-surgery

Invasive cervical resorption is characterized circumferential spread with/without coronal-apical spread in dentin where the involvement of the pulp may be delayed being present in advanced cases due to the presence of peri-canal resorption resistant sheet (PRRS) composed primarily of pre-dentin and odontoblasts Invasive Cervical Resorptive lesions have different radiographic presentations, ranging from a small radiolucency […]

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Redefining the access in retreatments: Part II of V
Retreatments

One of the most important steps of the endodontic therapy is the execution of the access cavity. Very often the failure of the therapy arises from an incorrect realization of this initial step, with consequences that can lead to the missing of canals, improper detersion and shaping of the root canal system or the fracture […]

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Obturation of root canals with impediments
Obturation Retreatments

Impediments (obstructions, obstacles) could be of anatomic (Figure 1) or iatrogenic (Figure 2) origin. Obturation of root canals with impediments potentially presents significant challenge for clinician and different approaches are often necessary in order to achieve successful outcome. If the straight master gutta-percha point won’t fit to length the first choice is to precurve gutta-percha […]

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Management of broken files - A clinical approach - Part 2
Separated instruments

We have discussed in the part 1 of this article how to remove broken files using ultrasonic technique (https://endodontics.styleitaliano.org/management-of-broken-files-a-clinical-approach/ ) but sometimes the ultrasonic (US) technique is useless when the broken file (BF) is LONG, ENGAGED or has a BIG MASS of METAL . So we need another technique to hold the broken file then pull […]

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Endodontic management of a tooth with large pulp stone
Anatomy

Pulp stones are discrete calcifications found in the pulp chamber of the tooth which may undergo changes to become diffuse pulp calcifications such as dystrophic calcification.[1] The number of pulp stones in a single tooth may vary from 1 to 12 or more, with varying sizes from minute particles to large masses which tend to […]

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The use of CAD/CAM technology
in the restoration of endodontically treated teeth

CAD-CAM EndoResto

Due to the biological and structural changes that the tooth undergoes during endodontic treatments,in principle it is mandatory that the teeth should be covered with a crown. The exceptation of this rule is mentioned in the first part of the article (direct restoration of endodontically treated teeth) In the indirect restorations we have to consider […]

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Endodontic management of mandibular canine with two roots and two canals
Anatomy

The aim of endodontic treatment is to eliminate microorganism infection from the root canal system and prevent reinfection.[1] Successful Endodontic treatment depends upon Adequate knowledge about the morphology of root canal system and diagnosing the anatomic variants to avoid missed canals, Therefore, the clinician should be aware of any anatomical variations which may alter the […]

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Apical fluid dynamics: the irrigant exchange
Irrigation

Syringe irrigation remains a widely used irrigant delivery method during root canal treatment. Unfortunately in the apical region there is always a limited liquid exchange due to physical and mechanical reasons. It means that the chemical actions of our irrigants can be limited and ineffective. Can we make the irrigant apical exchange more predictable in […]

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Management of iatrogenic root perforations: a case report
MTA

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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Mb2 as a first choice
Anatomy

This clinical case demonstrates how a strategy is important to approach in a proper way a difficult clinical case. MB1 scouting usually it’s easier and more predictable and only in a second time we dedicate our attention to MB2. Here instead, considering the difficulty of scouting MB1, it was decided to manage the situation  in […]

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