Our Articles & Clinical Cases

Mandibular molars exhibit one of the highest degrees of anatomical variability in the human dentition. While the classical configuration involves two or three canals, extreme variations exist, ranging from simplified two-canal systems to highly complex six-canal anatomies. When combined with apical pathosis, these anatomical extremes pose significant diagnostic and therapeutic challenges. Successful endodontic therapy is […]

A patient came to my attention complaining about impossibility to chew on the right side of the mouth. A defective restoration was found on the first upper molar, with a distal secondary decay. A decay was also present on the second upper molar. The diagnosis was of apical periodontitis in a previously treated tooth (16) […]

Successful endodontic therapy begins with a properly designed access cavity, which is the foundation for locating, cleaning, and shaping the root canal system. Inadequate or misdirected access can lead to missed canals, ledge formation, and iatrogenic perforations, severely affecting the outcome of treatment [1]. Understanding the pulp chamber floor anatomy—including color changes, developmental grooves, and […]

Re-treatment of C-shaped mandibular molars demands 3D cleaning and sealing beyond files; a stepwise strategy improves predictability.

Treatment for immature, necrotic permanent teeth is showing a paradigm shift in moving from a non-biological, barrier-creating approach (apexification) to a biological, tissue-regeneration approach. Conventional root canal treatment has a high long-term success rate (over 86%) for mature permanent teeth with irreversible pulpitis, pulp necrosis, or pulp exposure.  However, immature permanent teeth present more significant […]

Instrument separation is a well-recognized complication in endodontic practice, and its management can significantly influence the long-term prognosis of the tooth. While some fractured instruments are readily visible and accessible, others remain hidden, particularly when located beyond canal curvatures. Non-visible fragments pose a greater challenge, as blind retrieval attempts risk excessive dentin removal, perforation, or structural weakening of the root.

The c-shaped canal is an antomical variation that was first reported by Cooke & Cox in 1979 and mostly seed in mandibular molars, although it can occur also in mandibular premolars and maxillary molars

A challenging referral a previously initiated therapy complicated by a separated file in the mesial root and a multiplanar curvature.

Endodontic–restorative management of tooth 25 with periapical lesion: confirmed necrosis and 11 -months radiographic healing.

Mandibular molar retreatment due to an missed middle mesial canal. CBCT and Operanting Microscope are essential to identify the etiology and achieve three-dimensional disinfection. A Case Report

Variations in root canal anatomy, particularly the presence of middle mesial and middle distal canals, pose a significant clinical challenge.
Complex canal anatomies demand advanced strategies for effective cleaning, shaping, and obturation.
This article demonstrates how meticulous canal exploration, enhanced disinfection protocols, and bioceramic-based obturation can successfully manage such complexities, achieving a predictable three-dimensional seal.

Narrow long canals
Shaping challenges
Grasping tools
Conservative preparation
R one mini
Multiplannner curvature