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Non surgical retreatment of a mandibular first molar with C-shaped canal system

The C-shaped canal, which was first documented in  endodontic literature by Cooke and Cox in 1979,  is so named for the cross-sectional morphology of the root and root canal. C shaped canals are mostly present in the mandibular second molars, while they are really rare in the first mandibular molars. The cause of forming C shaped canals is the Hertwig’s epithelial […]

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Mechanical bypass of separated instruments

Check this case to see how it is possible to bypass separated instruments using FANTA Glider ST in reciprocating motion.

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Retreatment episodes, series 1

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 cases of […]

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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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The perfect fiber post removal

The fiber post removal is always a challenge and the clinician should be as conservative as possible. Different techniques have been suggested, but two of them are the most common: Ultrasonics and counter-angle burs.   The removal of posts from endodontically treated teeth can be a major obstacle in the retreatment of teeth. The goal […]

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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 […]

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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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Necrodontics - saving hopeless teeth

Both non-surgical and surgical retreatment procedures are performed when the primary treatment fails and we are trying to preserve the tooth. Usually the next attempt after the primary treatment is non-surgical retreatment and follow up. In some cases when we estimate that non-surgical procedures will not be helpful we can perform surgical retreatment with apicectomy.  […]

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Redefining the access in retreatments: part V of V

In the context of retreatments and re-access, very often it happens to perform a new endodontic therapy removing and sacrificing the old crown. The choice that the clinician must make in the presence of a pre-existing crown is related to a series of factors that can be summarized in the following diagram and were already […]

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Redefining the access in retreatments: Part IV of V

In the context of retreatments and re-access, sometimes it happens to perform a new endodontic therapy recovering the old prosthetic crown. A careful preoperative evaluation can allow the clinician to pick the best therapeutic choice and to address the wishes of the patient. The need to maintain the old prosthetic crown may arise from the […]

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Redefining the access in retreatments: Part III of V. The crown access management

In the context of retreatments and re-access, it often happens to perform a new endodontic therapy dealing with the presence of a crown. A careful pre-operative evaluation can allow the clinician, according with the patient's wishes, to face the best therapeutic choice. The opportunities are, in fact, those related to the removal of the pre-existing […]

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Management of the complex anatomy of a lower first premolar

An accurate diagnosis of the morphology of the root canal system is crucial in order to obtain a successful root canal treatment.  The prevalence  of three canals with three separate foramina in mandibular premolars is very rare like in the case that will be shown in this report: one canal leaves the pulp chamber, and […]

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