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Articles by this author

Dealing with intricate root canal system

In Endodontics, while managing curved canals , an exception to dealing with the intricate canal system could be when using advanced technology like rotary instruments or nickel-titanium files. These tools can help simplify the process by efficiently cleaning and shaping the canals, making it easier to navigate through complex canal anatomy. By utilizing such modern techniques, Endodontist can overcome the challenges posed by intricate canal systems more effectively.

Management of C shaped canal in mandibular second molar

C shaped root canal configuration is an aberrant canal anatomy, common in the mandibular second molars with prevalence ranging from 2.7% to 45.5% in different populations.  Failure of fusion of Hertwig’s […]

Premolar Endodontics

Complex anatomies in premolars pose significant challenges in endodontic treatment. Their relatively small size coupled with variations such as additional canals require specialized techniques and instruments. Effective management of these complexities demands a thorough understanding of canal anatomy and mastery of advanced instrumentation and obturation techniques. This article covers strategies for navigating one such complex anatomy, ensuring successful treatment outcome and minimizing complications.

Decision making when dealing with broken instruments 

The presence of a fractured instrument in a root canal is not, in itself, a cause of failure of the endodontic treatment. However, when this instrument prevents the complete disinfection […]

RCT Of A First Lower Molar with Five Canals And An Additional Distal Root

The chemomechanical preparation of the canal system is one of the most important phases of endodontic treatment and can be compromised in certain cases when performing a minimally invasive approach […]

Squirt Technique in Root Canal Obturation

Exploring the Squirt Technique for root canal obturation, its effectiveness, limitations, and the clinical application.

Pre endodontic build up importance

Endodontics, the branch of dentistry that deals with the treatment of the dental pulp and tissues surrounding the roots of a tooth, has advanced significantly in recent years. A critical aspect of this field is the pre-endodontic build-up, a procedure often necessary to ensure the success of root canal treatment. While it might seem like a routine step, its importance cannot be overstated. This article delves into the significance of pre-endodontic build-up, its benefits, and why it should be an integral part of every endodontic procedure.

Three roots in a first maxillary premolar: A case report

How often is this anatomical variation of maxillary first premolars? How can we detect it? How to treat such anatomy? In this article I will try to address these considerations.

Lower molar with narrow mesial canals

The root canal treatment of a lower molar with narrow canals is a complex and delicate dental procedure aimed at removing infected or damaged pulp tissue while preserving the tooth's […]

Case report Management of Dens Invaginatus type IIIA

This article showing the Management of Dens Invagenatus of upper lateral incisor with large periapical lesion.

Management of cervical Perforation, Apical abscess and huge periapical lesion

Root perforation is a complication of Endodontic treatment characterized by the communication between the root canal space with the periodontal tissues. These accidents usually occur due to iatrogenic causes including lack of knowledge of dental anatomy, wrong endodontic access, calcification of the coronary and cervical thirds, failure in radiographic analysis. Among the factors that affect root perforation prognosis are the location (cervical, middle and apical thirds), the extent, presence or absence of periodontal pockets, the time between perforation and treatment, biological compatibility and sealing ability of the filling material.

Pulp calcifications, a nightmare for the endodontist

Pulp calcifications are one of the main challenges faced by endodontic professionals. Pulp stones are defined as calcified foci that are observed in the coronal or, less frequently, radicular pulp […]

Radix Entomolaris: Case Report with Clinical Implication

Usually, first mandibular molars have one mesial and distal root but in some cases there are anatomical variations. Presence of an additional lingual root distally in mandibular molars is called radix entomolaris (RE). If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment. The article describes the endodontic management of mandibular molar with RE.

Retrieval and retreatment of mandibular molar

Retrieval along with Retreatment is one of the most challenging procedures in the endodontic therapy,  This article showcases the management of a lower first molar with swparatedinstrumemnt and a periapical lesion.  In […]

Management of complex anatomy in the first mandibular premolar, 2 cases in 1

We know that treating a tooth involves different phases or stages, but it is important to know the internal anatomy, in order to approach the case in the best possible […]

The Internal Isolation Technique: simplifying coronal perforation repair

The new calcium silicate based cements have many positive features compared to classic MTA, including a fast setting that could be used to speed up the process of perforation repair

Root fractures: clinical scenarios

Root fracture is a situation that may happen and is generally associated to these symptoms: Depending on the conditions, the symptoms referred by the patient may vary and, in some […]

Surgical management of Chronic Apical Periodontitis Due to an untreated Lateral Canal: A case report with 6-Month Radiographic Follow-Up 

Surgical treatment of apical periodontitis caused by a lateral canal, highlighting CBCT planning and bioceramic sealing for complete healing

Micro Rescue

Endodontic Microsurgery is one of the most important ways to save teeth rather than extracting and placing implant. Here we will talk about a tooth that failed multiple trials of endodontic treatment, endo-surgery was made and follow ups shows complete healing.

Single session endo resto treatment of an upper second molar

A smooth workflow in endodontics and restorative starts from the application of a strict protocol

Decision making in endo-perio-restorative cases of severely compromised teeth

The recovery of severely compromised teeth is a challenge for clinicians. Every day, we face this issue, and it is crucial to choose the correct technique and, above all, the […]

Multiple Complex Mishaps Management 

Endodontic mishaps can interfere with the healing process of the body and can result in failure of the root canal treatment if not taken care of. Perforation, if present should […]

Direct Vs Indirect restoration of endodontically treated teeth

The restoration of endodontically treated teeth must be planned before initiating root canal treatment. Because  Microbial contamination of the root canal system and peri-apical tissues is the most common reason […]

Magnification & Ultrasonics: the perfect marriage

The piezoelectric ultrasonics have the potential to become routinely incorporated into almost every component of endodontic treatment, re-treatment, and apical microsurgery. It is already indispensable as a precise tool with which the most challenging clinical situations, such as finding hidden root canals and removing root canal obstructions, can be done with relative ease, predictability, and conservancy. In this article, I will explain some of the uses of ultrasonics in conventional nonsurgical endodontics.

Retreatment

The failure of root canal treatment is a problem encountered by every dentist. A large number of studies have shown that teeth may continue to have previous periapical lesions or even develop new periapical lesions after root canal treatment. The reasons for root canal treatment failure, the site to be debreached, the method to be repaired, and the communication with the patient are all very important factors in retreatment.

Endodontic treatment of necrotic teeth with periapical lesion 

One of the most common complications after dental trauma is pulp necrosis, which is often associated with apical periodontitis. The management of these teeth is challenging due to large root canals, open apices, and thin dentinal walls. 1 Long-term irritation leads to periapical lesions and cysts in the apical region. If left untreated, necrotic and infected pulp causes inflammatory lesions in the periapical tissues to grow over time, leading to structural changes in the bone. In some cases, root canal treatment may be required later during follow-up of injuries, due to subsequent pulp necrosis and infection of the root canal system. 2-3

Re-treatment Decoding part 2: MB2, the most hated canal  

In this article we are going to review how can we deal with the most hated canal in Endodontics from diagnosis to obturation.

Simplified MTA apical plug

Root resorption is a pathological process that may occur after surgical mechanical, chemical or thermal insult. Generally, it can be classified as internal and external root resorption. Depending on the […]

External cervical resorption

External cervical resorption (ECR) is  an aggressive form of root resorption (RR), which initiates from the external cervical area of the tooth. Its aetiology is mostly unclear. As in this […]

3 rooted Lower Second Molar

Most mandibular second molars are usually found to have two roots (76%) or one root (22%). The incidence of 3 roots anatomy in such teeth is considered a rare finding […]

Retreatment of teeth with a complex root system anatomy #1

The second maxillary premolar  may have 1 to 3 roots: with one root canal in 75-96% of cases, with two root canals in 4-24% and three root canals in 0-1%. […]

Two Appointments Endo Resto: a simplified workflow to make prosthodontics helpful to endodontics

The aim of the article is not to introduce a new technique, but to combine existing and consolidated ones in order to maximize the ergonomics, quality and predictability of our treatments; the proposed protocol was designed to satisfy the work mantra "the best work, in the shortest time, in the greatest comfort" and therefore entirely focused on reducing chair time and maximum operational facilitation.

How to desobturate Thermafil

Amongst the different stages of endodontic retreatment, filling material removal may be performed by using manual files and rotary instruments. Further, desobturation may be associated with ultrasonic activation and different types of solvents, although they are currently used with less frequency. However, no retreatment technique is reliable enough to clean root canal system completely after reinstrumentation.

Apical plug with Bioceramic putty

The purpose of this article is to explain all the phases to do in a correct way an apical plug. Today on the market there was a lot of material […]

The broken file to retrieve or to leave ?

Endodontic cases involving broken instruments are among the most challenging and stressful in the field. Even the top experienced endodontists will agree that removing broken tools demands unwavering calm and […]

Perforation repair

Perforation is an iatrogenic communication that is formed between the tooth and supporting tissues. It is important to manage perforations as soon as they are diagnosed. An ideal peforation repair material is Mineral Trioxide Aggregate.

Middle mesial canal – a case series

Middle mesial canal (MMC) is an additional canal found in mandibular first molars. The knowledge of its presence and its detection, negotiation, disinfection and sealing plays paramount importance in the […]

The endodontic ledge: causes and management

As endodontists we often encounter retreatment cases with procedural errors such as canal blockages, ledges, instrument fractures and perforations.  The ledge is defined as an iatrogenic deviation from the original […]

Dental Diagnosis Dilemma

Dentistry is all about combining clinical art & science of diagnosis to improve the quality of patient’s life. Here we will talk about a patient with a molar needed to be retreated and instead she was misdiagnosed with trigeminal neuralgia.

Four-Rooted Maxillary Molars

The maxillary first molar typically exhibits complex root canal anatomy, commonly presenting with three roots—two buccal and one palatal. However, anatomical variations, such as the presence of a fourth root, […]

Rotation and Reciprocation: Synergy not rivalry

Many times we hear about rotation and reciprocation as rival movements and feel like we have to choose one or the other. In reality both are very important and helpful […]

Non-surgical endodontic treatment of large periapical lesions

This article showing the method of using non-setting calcium hydroxide in case with large periapical lesion .

Endodontic Surgery: A Conservative Solution in Some Cases for Preserving Natural Teeth

A patient recently visited our clinic with a complaint of persistent pain in the upper right lateral incisor. Upon examination, we discovered a granuloma at the root of the affected […]

Selective Root Canal Re-Treatement of Lower Left Pre-Molar

In retreatment cases , the clinician has to deal with many mishaps such as underfilled, missed and obstructed canals as also with iatrogenic damages as separated instruments and perforations. Underfilled […]

Retreatment case: metal post removal and deep splitting canal

There are four options for managing a tooth with posttreatment disease: do nothing, extraction, non­surgical retreatment, or surgical treatment. Avoiding treatment may result in the progression of disease and continued […]

Management of complicated crown fracture of newly erupted maxillary central incisor. Conservative approach with 3 years follow up

Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. One of the options for managing coronal tooth fractures when the tooth fragment is available is the reattachment of the dental fragment. This article reports on coronal tooth fracture case that was successfully treated using tooth fragment reattachment.

Management of anatomy in a first tricky premolar (Deep Split)

The clinician must be aware of the possible anatomical variations of these teeth and their relationship to adjacent anatomical structures when planning and performing endodontic procedures.

One canal, two broken files

The position and anatomy of upper molars can make root canal treatment challenging, and instrument separation is common. In the presented case, tooth 1.6 had an abscess, and an attempt […]

Retreatment case with two types of perforations

Root perforations were the second greatest cause of failure accounting for 9.62% of all unsuccessful cases. Seltzer et al. also attributed 3.52% of all endodontic failures to perforation. This perforation […]

The Problems of Pulpotec Material 

Narrow canal is a great challenge to Endodontist, When combined with calcified entrance the difficulty doubled. Preoperative assessment to the periapical radiograph would help in avoiding many errors that could […]

Single Cone Obturation: Mastering The Technique with Bioceramic sealers

The final objective of endodontic treatment as described by Schilder in 1967 is ‘‘the total obturation of the root canal space’’ and since then many materials and techniques have been […]

Retreatment case:Metal post removal and deep splitting canal Retreatment case:

There are four options for managing a tooth with posttreatment disease: do nothing, extraction, non­surgical retreatment, or surgical treatment. Avoiding treatment may result in the progression of disease and continued […]

Retreatment of teeth with a complex root system anatomy #1

Modern endodontic treatment is based on optimal cleaning,disinfection and high-quiality obturation of the root canal system.Anatomy is considered as a key factor in the healing process.That is why a clinician have to be aware of all normal,possible and abnormal variations in the teeth anatomy for achieving a maximum clinical success.In the article presents clinical example that demonstrate the complexity of endodontic retreatment of the maxillary left premolar

Dental Trauma: Forever classic, Never boring

A 23 years old, female patient, was referred to my practice for an endodontic treatment on tooth 11. Patient complained of pain above the root and was concerned of the […]

Pulpal Floor Perforation repair with the use of MTA cement

Perforation repair with MTA

A story of a dilacerated premolar

Premolars are the most versatile teeth in regards of anatomy. One of the most challenging anatomical variations we have to face is dilaceration. Abrupt curvatures complicate the RCT especially when […]

Bridging the Gap: How Today’s Endodontics Overcome Past Limitations

As modern dentistry continually strives for excellence, we frequently face the challenge of dealing with complications from older endodontic treatments, which often present unexpected difficulties. Calcifications, perforations, and stubborn obturation […]

Zoning Technique in Endodontics

The Zoning Technique is an innovative approach in endodontics that aims to optimize root canal treatment by dividing the root canal system into distinct zones and applying specific instruments and techniques tailored […]

A C-shaped story: endodontic management  and endocrown rehabilitation

The C-shaped root canal configuration is an anatomical variation which is caused by the fusion of the mesial and distal roots either on the buccal or lingual root surface (1). […]

Endodontic retreatment: expect the unexpected

The goal of an endodontic treatment is to disinfect the root canal system. This will facilitate the resolution of inflammation and the alleviation of symptoms. Failure to achieve this goal […]

Managing Calcified Canals: Techniques and Strategies for Successful Endodontic Treatment

A 32-year-old man with a symptomatic maxillary right central incisor came to the private clinic. The patient reported that the incisor had been traumatized previously. The medical history was nonsignificant, […]

The restorative aspect of endodontics: Part I: Pre-Endo build-up

Pre-endo build-up is an essential part of the endodontic procedure. It has 4 main purposes. First of all, it confirms that the tooth is restorable by means of isolating the […]

Dealing with hard canals, the easy way. 

This article demonstrates the protocols followed on two teeth with unique anatomical features in a conservative, feasible, teachable and repeatable way. 

The probability of two fives

With increasing number of reports and studies of unusual root canal morphology, It is of utmost importance that the clinician must have detailed knowledge of the pulp canal anatomy to achieve effectively proper cleaning and shaping of the root canal system. Failure to recognize the aberrant root canal anatomy will lead to an unsuccessful treatment and thus failure of the endodontic therapy. This case report describes a very rare scenario of a mandibular right first molar with five root canals (three in distal root and two in mesial root) and a maxillary left second molar with also five root canals (three in the mesial buccal root, one in the distobuccal root, and one palatal) in the same patient.

Inner wall Vs outer wall

This article is about showing the way of bypassing SI from both inner and outer wall, and which is correct in order to obtain satisfying outcome away from any unnecessary complications.

Trace every tract!

Sinus tract tracing, proper diagnosis, and patient education are all the big players involved in this tooth story! It is no surprise that I find all of advanced diagnostic techniques, i.e.; cone beam scans for example, extremely useful to figure out the source of pain plaguing my patients, it’s worth investing my time and energy into the latest technology. But keeping things old-school has its value too. Therefore, I would like to show you a case where a classic diagnostic method—sinus tract tracing—proved invaluable in my endodontic diagnosis.

Re-treatment Decoding : obturation dilemma   

In this article we are going to share how to manage an upper first molar in a predictable way for a long-term successful re-treatment.

Management of the complex anatomy of lower premolars 

Variations in the root canal configurations are a great challenge for the endodontist during endodontic procedures. This necessitates the understanding of canal morphology before initiating the treatment.

Non-Surgical Root Canal ReTreatment of Failed Apicoectomy with the Use of MTA cement 

Teeth with previous apical resection and persistent apical periodontitis are usually re-treated surgically or with a combination of non-surgical and surgical re-treatment. Alternatively, nonsurgical orthograde treatment of failed apicoectomy can […]

A mandibular first molar with 6 root canals: 

One of the most important prerequisites for successful endodontic treatment is the adequate knowledge and understanding of root canal anatomy. The mandibular first molar (MFM) seems to be the tooth […]

Removal of separated files; More than one way to achieve.

Fractured endodontic instruments visualized on the initial radiograph of a case that calls for retreatment may pose a great challenge to the clinician who is being asked to undertake an […]

Cracked tooth syndrome

Within the intricate landscape of dental health, the phenomenon of cracked teeth poses a challenging conundrum for both patients and dental professionals. Cracked teeth, an umbrella term encompassing various fissures and fractures within tooth structures, present a complex array of symptoms and diagnostic intricacies, often defying conventional diagnostic methodologies. This exclusive article aims to delve into the multifaceted nature of cracked teeth, exploring their diverse manifestations, diagnostic challenges, and tailored approaches to comprehensive management.

Silver points retreatment

In this article, I will discuss the retrieval of Silver Point Cones using the grasping technique

By-pass with style

The main purpose of an endodontic treatment is to render the root canal system free of bacteria. This will facilitate the resolution of inflammation and the alleviation of symptoms. But […]

Expanding the limits of Tooth Restorability

Nowadays, it is a common thing to have patients with extensive dental tissue loss because of caries. However, high magnification and the use of new technology and techniques help us […]

Optimizing Endodontic Outcomes through Selective Root Retreatment

In field of endodontic retreatment, the traditional dichotomy between non-selective nonsurgical methods and selective surgical interventions has been redefined by advances in CBCT imaging. This technological leap has facilitated the […]

A Mandibular First Molar with Radix Entomolaris and Middle Mesial Canal: a case report

Case report of the endodontic treatment of a mandibular first molar with radix entomolaris and middle mesial canal

Bending preservation of gutta-percha in lower first premolar with 3 canals

This article clarifies how to to bend gutta-percha cone and preserve this bending even if the temperature of the body can straighten the master cone in deep apical splitting of the canals.

Management of separated instruments in different location 

Separation of nickel-titanium instrument during root canal treatment can cause serious complications that may lead to treatment failure. It prevents complete cleaning and filling of the entire root canal space. […]

Intracanal aspiration, an useful tool

During a root canal treatment, sometimes we need to remove liquids from the canals, for example during the irrigation procedure, in cases with abundant drainage o before to dry the canals with paper points. The use of a microcanula connected to the equipment could help us to aspirate inside the canals. This can be useful even to remove materials from root canal.

The so called “bioceramics”… Easy to place, less easy to remove!

Calcium silicate based cements have many positive features, however they can be difficult to remove if a retreatment is necessary.

Orthodontic Extrusion For proper Endodontic therapy 

The major problem with sub-gingival fracture is absence of adequate coronal ferrule and a compromised biological width. This usually complicates the application of the rubber dam during endodontic treatment. The […]

Deep split in lower first premolar

Mandibular first premolar usually have a one root and one root canal but it shows a wide variety of abnormal root canal anatomy. The occurrence of three canaled mandibular first premolar with deep apical split  is very rare, but it does occur. The incidence of a three-canaled mandibular first premolar is approximately 0.2%, making such teeth most difficult to manage endodontically.

MTA apical plug and internal bleaching for Upper Central Incisor

MTA (Mineral Trioxide Aggregate) apical plug is a technique used in endodontic treatment to create a barrier at the apex of the tooth. This innovative solution has revolutionized endodontics by […]

Everything changes except for anatomy!

As the complex anatomy of maxillary first molars is one of the major challenges in endodontic therapy, knowledge of the complicated root canal anatomy and configuration is crucial to ensure the success of endodontic treatment and prognosis. This article presents an endodontically managed maxillary first molar with special anatomy.

Triple trouble

In this article we are going to share management of a pulp stone associated with c-shaped canals in a lower second molar.

Middle mesial canal (MMC) in lower molars

The main canals in the mesial root of lower molars are the mesiobuccal and mesiolingual canals.  A middle mesial canal (MMC) sometimes is present in the developmental groove between the […]

Endodontic management of immature central incisor by apexification

Trauma or caries in young children or adolescents can cause pulp necrosis, which may arrest root development in permanent teeth. This in turn results in thin dentinal walls, wide-open apices […]

Management of  maxillary first premolars with particular anatomies

To obtain good results in endodontic treatment it is important to remove all microorganisms from root canal system, three dimensionally sealing and the placement of a good coronal seal to […]

Premolars with 4 canals is not a daily case

     The purpose of root canal treatment is to clear pathogenic microbes and infected pulp in the root canal, prevent it from producing toxic products, and protect the periapical tissue. […]

Non-surgical management of Large-Apical Lesion with Open Apex

Bacterial infection of the dental pulp may lead to periapical lesions. They are generally diagnosed either during routine dental radiographic examination or following acute pain in a tooth. Most periapical […]

Removing Gutta during retreatments: better using solvents from the start?

The use of solvents helps removing the filling material form the canals, however it may as well slow down the retreatment process. A case report

When Retreatment Fails…

The role of  endodontics is to save as many teeth as possibile. Today thanks to technology (Microscope, CBCT, New instruments) we are able to manage very difficult cases. It’s very […]

We all make mistakes - correct protocols help us detect them early

The in-depth knowledge of root anatomy and its possible variations is absolutely fundamental for the long-term success of our therapies. Sometimes, despite the aid of strong surgical magnification and despite good anatomical knowledge, one may come across particular anatomies in an unpredictable way. A correct operating protocol can protect us from errors, giving us the way to correct them without consequences.

Management of Multiplanar Curvature

In this article, I will discuss the method of diagnosing and analyzing multiplanar curvature, along with the treatment planning using the novel treatment approach.

Dealing with MM canal in a lower first molar

After conducting a lot of studies of the internal anatomy of the first mandibular molar, it was found that there is a lot of diversity in the internal anatomy of the tooth, and taking advantage of the studies that were conducted, it was found that the main reason of the failure of endodontic treatment occurs due to missing canal of the first molar. Therefore, one must understand and bear in mind the difference in the internal anatomy of the teeth when you need to do endodontic treatments.

Curvy Wisdom Management 

Third molars, or, more popularly, wisdom teeth usually erupt in most patients after the age of 17. Abnormal eruption patterns make them more susceptible to dental decay, as well as […]

Management of a C-Shaped canal in second lower molar

Anatomical variation of canals is well documented in the literature and C-shaped canal anatomy was first reported in literature by Cooke and Cox in 1979. This anatomical variation mostly found […]

Extraction or try retention?

The management of cracked teeth represents a difficulty because their diagnosis is complex and there is no consensus concerning their treatment

Endo-restorative treatment of discolored upper incisor

Every patient wants a functional, healthy, and esthetically appealing smile. This article describes a patient with discolored and fractured composite resin restorations with improper endodontic treatment on the anterior teeth in whom substitution was indicated. This treatment improves the endodontic and restorative aspects.

Endodontic surgery of the lower incisor: how important is it to verify the presence of a lingual canal?

The surgery of lower incisors should be performed carefully, assessing the possible presence of lingual canals, and avoiding the mistake of underpreparation by not adequately evaluating the clinical situation

Dens invaginatus

Dens invaginatus is malformation of teeth probably resulting from an infolding of the dental papilla during tooth development. Affected teeth show a deep infolding of enamel and dentine starting from the foramen coecum or even the tip of the cusps, and which may extend deep into the root. Teeth most affected are maxillary lateral incisors and bilateral occurrence is not uncommon. The malformation shows a broad spectrum of morphologic variations and frequently results in early pulp necrosis. Root canal therapy may present severe problems because of the complex anatomy of the teeth.  

MB3 in second maxillary molar

A case presentation of maxillary second molar with 3 mesio buccal (MB) canals.

The endodontic dark hole

Internal resorption is a complex case that requires multiple tools and knowledge to treat it properly. Internal resorption is a condition in vital cases where is the loss of dentin […]

Geriatric endodontics: case report and clinical considerations

The increased life expectancy has led to the increase in numbers of elderly patients seeking dental treatments, and more precisely root canal treatments. According to a survey of diplomates of […]

Management of a deep bifurcation in a mandibular first premolar, with small instrument fractured in the middle third

It is very important to identify obstacles and plan any strategies from the beginning to avoid problems that could cost us the success of the treatment   Preoperative radiograph identification, […]

Non surgical retreatment of a lower first molar

In this article we are going to share management of a lower first molar with a non-surgical re-treatment (NSRT) approach.

Silver cones still alive…

Retreatments in endodontics are always a challenge. Nowadays above all for Endodontist retreatments are a daily routine. Each case is different and it’s important have the right tools and the […]

MB2: locating and accessing

As we know, the presence of a second canal in the mesiobuccal root is very common in upper molars. This second canal is usually more difficult to treat, due to its location and anatomy. In the article, we will describe how we can locate it, and how to properly manage the entrance of the canal, in order to carry out adequate instrumentation of it.

Gemination  or  fusion

Dental anomaly is a condition in which one or more teeth deviate from the normal in form, function, or position. And it includes abnormalities in teeth number, size, shape and […]

Management of deep split in mandibular premolar

A thorough knowledge of the root canal anatomy and its variation is required for achieving success in root canal therapy, along with diagnosis, treatment planning and clinical expertise. Outcome of […]

How To Manage A Ledge - A case report

Among all the difficulties we encounter during the reconstruction of an incongruous root canal therapy, a very difficult challenge is always represented by overcoming false paths and ledges mistakenly created […]

Management of an upper second molar with a restorative approach

Adhesive procedures have changed the way of restoring endodontically treated teeth. Postless approaches have been proposed to improve and restore teeth. The preservation of the dental structure of endodontically treated […]

Clinical Tips for Managing Calcified Canals

One of the causes of endodontic treatment failure is calcification in the canal pathway, which prevents complete access to proper working length. In some cases, the dentist is unable to […]

Challenges with retreatment of  Russian red aka Resorcinol-formaldehyde teeth

Retreatment is considered a difficult manipulation that requires the knowledge, experience and technical equipment from the doctor. Resorcinol-formaldehyde therapy is no longer used as a medical material, but since the 1960s it was widely used in different countries, which increases the chance of such a patient getting into your daily practice. The article discusses the clinical scenarios developed because of the use of the mentioned material and ways to deal with it.

Different treatment modalities in a molar

Before performing any root canal treatments you should have knowledge on how to face any problems you face during treatment. In this case we switched treatment plan in the middle […]

Dens Evaginatus - A case report

Dens evaginatus (DE) is a relatively rare developmental anomaly that occurs more often in people of Asian descent than European descent. DE appears as a cusplike elevation of enamel, referred […]

Fiber post placement with new tools

Ergonomics in dentist refers to designing tools, equipment, and workspaces to reduce health risks for operators and patients while improving posture and movement and optimizing the results for the patients.an […]

Retreatment of a first mandibular molar with three independent mesial canals

One of the most common causes of failure in endodontics is missing canals. The middle canal in lower molars is not an exception and has been studied by numerous authors in the literature. Its prevalence ranges from 0,28% to 53,8% and it’s specially presents in the mesial root. Using different X-ray angulations or with the help of CBCT we can confirm its existence. Understanding the anatomy of the teeth is a key factor for the success of our treatment. In this case we are treating a previously treated lower molar with some hidden anatomy.

MTA apical plug

MTA has several desirable properties that makes it an excellent choice for apical plug formation .  Firstly , biocompatibility to the surrounding tissues . This is crucial for achieving successful […]

Vital pulp therapy

Endodontic treatment is the most common procedures that performed in daily clinic routine the aim of endodontic therapy is to treat the infectious situation caused by bacteria from carious lesion […]

The braiding technique

In this article, we are going to explain the Braiding Technique, a predictable way to remove materials from inside root canals.  For this technique, we will use Hedstroem files, and […]

Making apical plugs easier using a simple collagen sponge

Proper seal of the root canal system is a key factor for long term success of the endodontic treatment. In the majority of cases, the root anatomy and the apical […]

Management of large floor perforation 

Perforation (often of the floor) is one of the problem to solve that can happen when we start to do a retreatment. There is a lot of confusion and question […]

Management of C-shaped canal system

A thorough knowledge of the root canal anatomy and its variations is required for achieving success in root canal therapy, along with diagnosis, treatment planning and clinical expertise,  One such […]

Little molars

The presence of 3 rooted premolars called, little molars, is pretty infrequent. Found in only 1-4% of cases with regional variation. The two morphological types involve either two buccal and […]

Management of mandibular first premolars with unique anatomies

A thorough knowledge of root canal anatomy is essential for predictable and successful outcomes of endodontic therapy. Mandibular premolars are rightly called “endodontist’s enigma” by Slowey, as they are known […]

Endodontic retreatment of a mandibular first molar with missing Mid-Mesial canal

The presence or absence of periradicular disease is determined according to clinical and radiographic findings. This article will discuss the non surgical endodontic retreatment of a mandibular first molar with […]

Management of deep apical split

Speaking of ANATOMIC VARIATIONS The clinician should be aware of root canal anatomy and morphology, not to mention the protocol of debridement, disinfection and obturation.  Vertucci5 reported the incidence of […]

Management of deep root perforations

Root perforation is a challenging situation when the root canal has a pathological communication with periradicular area. Perforations can occur as an iatrogenic accident during a root canal instrumentation and […]

Shaping different anatomies

Anatomy is one of the biggest challenges in the root canal treatment. During the step of shaping lots of errors may happen like zipping, ledges, transportation, straightening the anatomy and file […]

Retreatment of Mandibular First Molar

There have been many recent technical advances in modern endodontics that have the potential to affect treatment outcomes. The purpose of this article is to determine the success of nonsurgical root […]

Management of S-shaped root canals

Straight simple root canals are rare in the human dentition; the majority present with complexities and curvatures in different planes, making the endodontic treatment a complex task that requires adaptation […]

Apical lesion from formation to healing 

Apical periodontitis serves an essential protective function aimed at confining bacteria discharged from the root canal space and preventing them from spreading into adjacent bone marrow spaces and other remote […]

Management of Immature Permanent Incisors with wide open apex

A major problem associated with treating traumatized teeth with necrotic pulps and open apices, is achieving an acceptable seal in the apical area. Apexification has traditionally formed an integral part of the […]

Management of deep splitting root canals

Endodontic management of a tooth is an interesting and challenging procedure that is partly blinded, and its success depends on individual clinical expertise and skill, as well as the procedural […]

Management of severe trajectories: a clinical perspective

The curved and dilacerated roots in the posterior teeth often present the major challenge to the clinicians during the endodontic treatments. Failure to secure a safe glide path in order […]

Root perforations: from breakdown to breakthrough

In retreatments, one of real endodontic challenges comes when disassembly is complete and what remains is a root canal system that has been perforated.  What is the critical thinking required […]

How to deal with EIAE? A case report

EIAE (Endodontic interappointment emergencies) is a complication commences a few hours or days after root canal procedures and it is characterized by the development of pain and/or swelling. Despite the […]

Pre-endodontic build up of an upper second premolar

One of the main objectives in endodontic treatment is the disinfection of the root canal system. However, most of the time we face severely destroyed teeth, which means a challenge […]

Radix entomolaris- a case series

Endodontic treatment entails thorough chemo-mechanical debridement and disinfection of the pulp spaces, followed by placement of an inert biocompatible material to allow hermetic sealing of the root canal system. Inability […]

Management of a Type III Radix Entomolaris in a first lower molar

Understanding the anatomical variations of the root canal system is a must to achieve the main goals of our treatment. The radix entomolaris is the most common variation in mandibular […]

Retrieve and repair

As Endodontists our daily work is an adrenaline fuel because we face new challenges on a daily basis and each case requires a strategy to fix it. Strategy before any […]

How To deal with Splits " Different Scenarios "

Failure to locate and disinfect all the root canals may be a major reason for endodontic failure. The first Step to reach the success of root canal therapy is to have […]

Trend or trap?!

An endodontic access cavity is an important first step in successful endodontic treatment. Lately, strongly constricted endodontic access cavities have become quite popular, the idea of which serves to save […]

Poor prognosis?...

A case presentation of hemisectioning of the distal root of a LR6 due to fracture, and 6-year review.  The clinical aspects and considerations are discussed. Occasionally, during our practice, we […]

Management of ledge formation

The ledge, which is a deviation from the original canal curvature without communication with the periodontal ligament, is created when the working length can no longer be negotiated, and the […]

Endodontically treated tooth dyschromia: causes and solutions

The discoloration of a dental element can create a strong aesthetic discomfort and can often be the first clinical sign of an ongoing pulp disease. The causes of dyschromias are […]

Management of molarized premolar with severly calcified and curved canals

This article clarifies how to deal with extra root canal system anatomy of premolars clinically and how you can manage and shape the buccal tinny and curved canals of molarized […]

Root canal treatment of an immature permanent mandibular first molar

The root canal treatment of immature permanent teeth poses many challenges, one of which is the obturation technique. These teeth come with wide apices and sometimes even a divergent configuration […]

Danger zone in C-shaped root canals

The danger zone is an area of the root canal where the primary thickness of dentin before preparation is under 1 mm. In general, the danger zone is located 4 […]

How to improve ergonomics in endodontics

Ergonomics in endodontics refers to designing tools, equipment, and workspaces to reduce health risks for operators and patients while improving posture and movement. Ergonomics in endodontics is extremely important to […]
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