According to Vertucci, mandibular premolars have one single canal in approximately 74% of the cases. On occasion, mandibular premolars have two canals, in around 25.5%, but higher numbers are very […]
Expect the unexpected : Four canals in mandubular premolar
According to Vertucci, mandibular premolars have one single canal in approximately 74% of the cases. On occasion, mandibular premolars have two canals, in around 25.5%, but higher numbers are very […]
Apexification of an immature mandibular premolar: a case report
Apexification is a treatment procedure aimed at creating an apical barrier in a non-vital immature permanent tooth with incomplete root development and an open apex. The absence of apical constriction makes canal disinfection, obturation and the achievement of a predictable apical seal particularly challenging.
The purpose of this case report is to describe the non-surgical endodontic retreatment of a previously treated immature mandibular second premolar with symptomatic apical periodontitis. An MTA apical barrier was created to provide an effective apical seal, followed by root canal obturation. Follow-up demonstrated resolution of symptoms and favourable periapical healing.
Impossible is possible with the right protocol
Impossible cases might be possible and worth your time.
But you should always approach cases like these with the right protocols to avoid making iatrogenic errors.
Dilacerated roots are one of the hardest anatomies any clinician can ever face.
Periapical osteoperiostitis: CBCT diagnosis and healing following endodontic retreatment
CBCT revealed periapical osteoperiostitis with recurrent unilateral sinusitis, resolving after endodontic retreatmentt.
Beyond Canal Number: Anatomical and Clinical Challenges in Maxillary Premolars – A Case Series
Maxillary premolar cases highlight how anatomy and technical factors can turn expected root canal treatment into a clinical challenge.
Expect the Unexpected: Anatomy Twist in Maxillary Second Premolar
The maxillary second premolars are generally known to have a single root and one or two canals, with the most common canal configuration being one canal (Type I) or two canals merging into one (Type II or III).
However, a rare and noteworthy anatomical variation exists: the presence of three roots.
While this variation is more frequently seen in maxillary first premolars, three-rooted second premolars are uncommon and present unique clinical challenges. This article explores the prevalence, clinical implications, and endodontic management considerations for three-rooted upper second maxillary premolars.
Non-surgical healing of a large periapical lesion in maxillary anterior region
Periapical lesions develop as a result of invasion of microorganisms or their toxins from necrotic pulp tissue in the periapical tissue, leading to acute or chronic inflammation. It has been […]
Management of Two Broken Intruments in an Upper Right Canine – A Clinical Approach
Instrument separation is one of the most common complications encountered during root canal treatment. Although fracture of the instrument itself may not directly cause treatment failure, retained fragments within the […]
Selective Root canal retreatment
This approach focuses on retreating only the specific canal(s) associated with persistent infection or radiographic pathology, while leaving unaffected, well-obturated canals untouched.
It offers a minimally invasive alternative that preserves tooth structure, avoids unnecessary disruption of posts or restorations, and reduces treatment time and patient discomfort.
Selective retreatment requires precise diagnosis, careful case selection, and the use of modern technologies such as CBCT and magnification.
Internal bleaching of endodontically treated teeth
Teeth discolorations can be extrinsic or intrinsic. The first type is usually caused by food, drinks, smoking and other substances that lead to the deposit of stains on the enamel. […]
Three-Year Clinical Follow-Up of Quadrant Restoration After Removal of a Fractured Root Canal Instrument: A Case Report
A substantial portion of clinical dental practice comprises endodontic and restorative procedures. Among these, quadrant rehabilitation frequently presents as a common and complex clinical challenge. During quadrant rehabilitation, the replacement […]
CBCT-guided management of external cervical resorption in a mandibular premolar
External cervical resorption is often silent, yet treatment planning becomes complex when a subgingival lesion is close to the root canal space. In such cases, the clinical view may underestimate the defect. CBCT provides the information required to define the portal of entry, height, circumferential spread and relationship with the canal.
This case report presents the management of an asymptomatic tooth 44 in a 62-year-old female patient, diagnosed with a Patel 2A external cervical resorption lesion. Treatment combined surgical exposure, removal of fibrovascular resorptive tissue, adhesive repair of the defect and single-visit root canal treatment after identification of a second lingual canal.