Our Articles & Clinical Cases

Dens invaginatus is a developmental anomaly characterized by invagination of the enamel organ into the dental papilla before calcification, resulting in highly variable internal anatomy. The complexity of the root canal system may compromise diagnosis, debridement, irrigation and three-dimensional obturation. This case report describes the endodontic management of a Type II dens invaginatus in a […]

This case report presents the endodontic and restorative management of a mandibular molar with an unexpected middle distal canal. Five canals were successfully shaped, disinfected using combined sonic and ultrasonic activation, and obturated with a warm modified technique, followed by a conservative restorative workflow culminating in an adhesive overlay.

Three-rooted maxillary premolars represent an uncommon but clinically important anatomical variation. The maxillary first premolar most frequently presents with two roots, while the occurrence of three separate roots is considerably less common. In a CBCT study of 350 maxillary first premolars, Olczak et al. reported three roots in 2.6% of teeth, with two-rooted morphology accounting […]

Provides Straight Line Access is mandatory.
A properly designed access cavity provides straight line access to the root canals, facilitating efficient and controlled canal shaping. This reduces unnecessary stress and torsional forces on endodontic instruments, thereby minimizing the risk of instrument separation during root canal treatment.

Nonsurgical root canal treatment with an apical plug to avoid extraction in a patient on active oral bisphosphonate therapy and root resorption.

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 uncommon. Finding four separate canals is extremely rare anatomical variation. The canals are classified as mesiobuccal, distobuccal, mesiolingual and distolingual canal. This significantly increases the […]

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 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.

CBCT revealed periapical osteoperiostitis with recurrent unilateral sinusitis, resolving after endodontic retreatmentt.

Maxillary premolar cases highlight how anatomy and technical factors can turn expected root canal treatment into a clinical challenge.

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.

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 proven that the majority of inflammatory periapical lesions can be effectively treated using nonsurgical endodontic management. However, the selection between surgical and nonsurgical endodontic treatment […]