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Dens invaginatus

Dens invaginatus is malformation of teeth probably resulting from an infolding of the dental papilla during tooth development. Affected teeth show a deep infolding of enamel and dentine starting from the foramen coecum or even the tip of the cusps, and which may extend deep into the root. Teeth most affected are maxillary lateral incisors and bilateral occurrence is not uncommon. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of the complex anatomy of the teeth.  

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Management of a Type III Radix Entomolaris in a first lower molar

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, […]

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CBCT guided treatment planning and management of instrument fracture in the mesial root of a second mandibular molar

Instrument fracture can be a very frustrating complication in Endodontics. Many factors determine whether a separated instrument should be removed or not from the root canal system. The aim of this case report is to highlight the usefulness of LFOV CBCT in the treatment planning of a second lower molar with a fragment in the […]

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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 […]

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Management of Missed Canal Part 1: Lower First Molar

It is reported that almost 40% of retreatment with chronic apical periodontitis or symptomatic apical periodontitis are due to missed canals. Karabucak & all reported in 2016 an overall incidence of missed canals in treated teeth to be 23.04% and 41 to 46% in maxillary first molars. Teeth with a missed canal were 4.38 times […]

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Unusual anatomy in upper second molar

The hard tissue repository of the human dental pulp takes on numerous configurations and shapes. A thorough knowledge of tooth morphology, careful interpretation of angled radiographs, proper access preparation and a detailed exploration of the interior of the tooth are essential prerequisites for a successful treatment outcome. CBCT, Magnification and illumination are aids that must […]

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Invasive Cervical Resorption Part1: Conservative Non-surgical management

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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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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