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Huge Perforation!

Retreatment is one of the biggest challenges for the clinician due to the unexpected surprises, prognosis and diagnosis which may be tricky in many situations. In this case, this female patient was complaining about pain during biting, related to a previously treated tooth.

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Management of internal root resorption in a maxillary central incisor

Root resorption is a particular physiologic or a pathologic pulpal disease associated with loss of dentin, cementum, and/or bone. This resorption may occur following different types of injuries, including chemical, mechanical or thermal injury. Furthermore, it can be cla classified as internal or external root resorption. Internal root resorption (IRR), is a rare condition that […]

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Regenerative endodontics: A Reliable Option

Various regenerative endodontic treatment (RET) protocols have been suggested with differences mainly in the disinfection technique used, intracanal medicaments, scaffold systems, and coronal filling materials. In order to reduce such variability, the American Association of Endodontists (2013) and European Society of Endodontology (2016) developed evidence based recommended protocols. These guidelines helped reduce some of the […]

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Retreatment Series: Episode 2

Root canal retreatment seems to be one of the biggest challenges in the Endodontic therapy, in the retreatment episodes we will review different scenarios with different cases. In Endodontics we are dealing  with a lot of challenges such as anatomy, mishaps, instrument separation, etc. but one of the biggest challenges is to deal safely with […]

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The management of a buccal perforation in a lower incisor

Root perforations are characterized by a communication between the root canal system and the external tooth surface. They are caused by a pathological process or an operative procedural accident. When iatrogenic, they can occur during access cavity opening, root canal preparation or during post preparation. Root perforation needs to be diagnosed early and treated appropriately as soon as possible, since they may cause an inflammatory […]

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The management of two mandibular molars with apical inflammatory root resorption

Apical pathology can appear as a straightforward diagnosis, however the tools available for assessment come across different limitations. Histology has highlighted various aspects that can not be yet coherently linked to a clinical situation using imaging investigations (Ricucci, Mannocci & Pitt Ford, 2006). Inflammatory root resorption makes no exception and reveals itself on periapical x-ray […]

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Lower second molar: carrier based obturation...through the furcation

Perforations are defined as artificial communications between the root canal space and the surrounding tissues. Endodontic perforations represent an interruption of the continuum between the endodontic space and the periradicular tissues, periodontal tissues or oral cavity.  In the presence of perforation, studies report a 10 to 12% increase in the failure rate of endodontic procedures.  […]

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Vital Pulp Therapy: Part 1: Direct Pulp Capping for A Traumatic Exposure of Permanent Maxillary Right Central Incisor

Pulp inflammation or exposure may occur as a result of many reasons like carries, trauma, or over-zealous preparation. However, if left untreated, this may lead to pulpits, pulp necrosis, and then apical periodontitis, which means more cost and chair-time spent. In addition, more tooth structure loss would jeopardise the survival rate and the outcomes of […]

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Saving hopeless tooth: case report

With introduction of mineral trioxide aggregate and other bioactive materials in endodontics possibilities of saving compromised teeth have improved significantly.    

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Perforation repair: step by step

A tooth perforation is a pathologic or iatrogenic communication between the root canal space and the periodontal apparatus. To clinically determine if an endodontically perforated tooth should be extracted or saved, the clinician must first understand the prognosis and treatment. The biologic response of a perforated tooth is inflammatory and can cause a breakdown of […]

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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 […]

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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 […]

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