Re-treatment of Upper right Second Premolar
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. Reading a preoperative periapical radiograph is of utmost importance. Though, […]
Redefining the access in retreatments: Part II of V
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 […]
Obturation of root canals with impediments
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 […]
The removal of filling material during retreatments
The prognosis of initial endodontic treatment is mostly favorable . Nevertheless, failure can occur due to the persistence of bacteria following initial treatment or due to inadequate disinfection, shaping and obturation of the root canal system. The possibility of a secondary infection is also not to be excluded, especially when a defective coronary reconstruction leads […]
How to remove Eugenate-based cements and gutta-percha
The removal of gutta-percha and sealer from endodontically treated root canals is the first step of any retreatment of teeth obturated with these materials. Gutta-percha is the most common obturation material, used in conjunction with various sealers. The removal of gutta-percha from root-filled teeth is required not only for the retreatments, but also to prepare […]
Endo - Resto Relationship
The predictors of success and failure in endodontically treated teeth depends on several factors: Apical Pathosis, Bacterial status of the canal prior to obturation, Extent and quality of the obturation and Quality of the coronal restoration, Torabinejad 2008(1). These need to be emphasised since majority of endodontically treated teeth have a badly compromised tooth structure […]
Redefining the access in retreatments: Part I of V
One of the most important step of 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 until the fracture of […]
Alternative method for removing fractured instrument: a case report
An alternative method, involving the use of an irrigation needle and cyanoacrylate adhesive, allowed the removal of the fractured instrument from inside of the canal system. During the mechanical shaping of the root canal system, the possibility of fracture of an instrument is always present. When it occurs, the first step is dealing with our […]
Management of broken files - A clinical approach
You have a great day and you feel very relaxed while doing an endo treatment for a lower molar, everything is going well, the pulp chamber was opened correctly in a conservative manner, you found all the root canals while correctly following the floor map, then starting instrumentation, shaping, and cleaning procedures; you feel that you are playing […]
Practical tips in ledge management
Endodontics is nowadays becoming more and more user-friendly with modern rotary or reciprocating files; however despite introducing new products, protocols are still prone to failure. One of the most common problems in endodontics is the formation of a ledge. This deviation from the original canal can be fatal for a tooth. Managing a ledge can be a […]
Endodontic Flare-up
The occurrence of pain and/or swelling after an endodontic treatment is not uncommon in endodontic practice, and can be a frustrating event for dentists and a disappointing surprise for patients. As stated by the American Association of Endodontics Glossary, a flare up is defined as an “acute exacerbation of asymptomatic pulp or periradicular pathosis after […]
Root canal disinfection during retreatments: a cordless revolution
The ultimate goal in endodontics is the complete removal and disinfection of the root canal space. The question is if that goal is truly achievable utilizing the conventional techniques we are currently taught. And what about retreatments? Retreatment of endodontic failures is a significant portion of endodontic specialty practice and failure might occur in case of […]