Dental Health News Blog Illinois | Renovo Endodontic Studio

Endodontic Treatment Planning Dilemmas

ENDODONTIC TREATMENT PLANNING DILEMMAS

Posted on December 7, 2017 (March 24, 2021) by Jonathan Wong

ENDODONTIC TREATMENT PLANNING DILEMMAS: Here we present an interesting case of a 47yo healthy Asian male with an exceptionally esthetic FPD #3-5 with #4 as the pier abutment. The FPD was done a little over a year prior to initial presentation to our office. The patient had subsequently presented to our office with persistent bite discomfort and pain upon digital palation of the “gums”. Although both #4 and #5 were infected, #4 had a vertical root fracture traveling from the apical –> coronal (confirmed via CBCT and subsequent surgical access). Apical surgery was initially planned on #5 and full root […]

Why Does My Endodontist Do Extractions?

WHY DOES MY ENDODONTIST DO EXTRACTIONS?

Posted on October 4, 2017 (March 24, 2021) by Jonathan Wong

WHY DOES MY ENDODONTIST DO EXTRACTIONS? There are several clear benefits of working with endodontists who are comfortable with extractions: (1) If a tooth is found to be non-restorable during treatment due to a severe crack or fracture, we can immediately remove the tooth while they are already numb without having to send the patient to another dentist who may not be able to see them for severaldays (2) It allows us to be somewhat ‘unbiased’ with regards to recommending either RCT or EXT treatment options. However, comfort with extractions also allows us to increase our surgical repertoire to provide […]

Dental Trauma

DENTAL TRAUMA 2

Posted on October 4, 2017 (June 2, 2023) by Jonathan Wong

DENTAL TRAUMA: This 12 yo healthy boy presented to our office after his face had an unfortunate meeting with a bed railing while studying with his father. Fortunately, his parents were mindful enough to bring the fracture incisal edge with them to the appointment. Clinical exam determined that this is an Uncomplicated Crown Fracture (Ellis Class II). Although there was no pulp exposure, we can see blushing of the dentin from the occlusal photo. Pulp vitality testing was inconclusive because he was non-responsive to thermal stimulus; this is very common and traumatized teeth can be non-responsive for up to 2-3 months. […]

Endodontic Healing Potential

ENDODONTIC HEALING POTENTIAL 3

Posted on September 6, 2017 (June 2, 2023) by Jonathan Wong

ENDODONTIC HEALING POTENTIAL: AL……..MOST……THERE!! […]

Trauma and CBCT

TRAUMA AND CBCT

Posted on August 25, 2017 (March 24, 2021) by Jonathan Wong

TRAUMA AND CBCT: Yet another trauma case where CBCT evaluation was an integral part of diagnosis and treatment planning. This patient presented to our office two days after taking an elbow to the mouth during a volleyball match. The patient stated immediately following the incident, he noted bleeding of the gingival sulcus and pain tooth #8. He denied tooth movement or malpositioning. Tooth #8 had a full coverage crown, was tender to percussion and palpation, Class III mobility, no response to cold, no isolated deep probing depths, and widened PDL space in the apical third. Teeth #6, 7, 9, 10, and […]

Selective Root Retreatment Revisited

SELECTIVE ROOT RETREATMENT REVISITED

Posted on August 22, 2017 (March 24, 2021) by Jonathan Wong

SELECTIVE ROOT RETREATMENT REVISITED: Does it work? Here we present a case with a 45 yo healthy female with seemingly adequate endodontic treamtent but recurrent lesion associated with the mesial root. It may be of siginficance that the crown was recently replaced within a couple of months. We did not see defintive evidence of non-restorable tooth fracture. Therefore, 2 stage selective root retreatment was chosen to minimize “esthetic” damage to the crown. 1 year later, the mesial root lesion appears to have resolved and the patient remains symptom free and happy! […]

Trauma

TRAUMA

Posted on August 22, 2017 (March 24, 2021) by Jonathan Wong

TRAUMA: 15 y.o. male presented to our office 4 days following a moped accident which traumatized tooth #9. The patient stated tooth #9 was extruded approximately 2mm, and that he immediately pushed it back into the socket with his fingers. Tooth #9 clinically presented with Class II mobility, 3-4mm probing depths with heavy bleeding upon probing, and an exaggerated lingering response to cold. The PA radiograph demonstrated a mid-root horizontal root fracture. CBCT examination demonstrated an oblique horizontal root fracture approximating the palatal osseous crest. Despite guarded prognosis, it was in the best interest of the patient to maintain tooth […]

Endodontic Healing Potential

ENDODONTIC HEALING POTENTIAL 2

Posted on July 31, 2017 (June 2, 2023) by Jonathan Wong

ENDODONTIC HEALING POTENTIAL: Here we present a case of the potential of healing disease with proper endodontic treatment. Pre-operatively the case displayed a large distal root lesion with significant furcation involvement, buccal swelling and probing that could essentially reach the root apex. Without any definitive proof of non-restorable tooth/root fracture, including pre-operative CBCT, we decided to initiate root canal treatment with the intent of saving the tooth. Upon the initial appointment the case was completely instrumented and medicated for 8 weeks (no sponge/cotton pellet used). At the completion appointment, we had already noted significant lesion healing with no clinical signs […]

Failing Chin Augmentation or Infected Retention Screw?

FAILING CHIN AUGMENTATION OR INFECTED RETENTION SCREW?

Posted on July 21, 2017 (March 24, 2021) by Jonathan Wong

FAILING CHIN AUGMENTATION OR INFECTED RETENTION SCREW? Here is an interesting case with the following presentation… – 42 yo healthy female – Chief Complaint: Recent onset pain on the LR chin area – Hx of facial reconstruction including mandibular surgery to address significant Class II malocclusion – Chin augmentation also performed at that time; outlined by red arrows – CBCT shows the location of the chin graft with a radiolucency at the interface of graft and communication with root apices of #26 and #27 – Surgery done in 1989 – Recent onset discomfort associated with #26, 27 area with radiographic […]

Is Complete Canal Calcification Treatable?

IS COMPLETE CANAL CALCIFICATION TREATABLE?

Posted on July 18, 2017 (March 24, 2021) by Jonathan Wong

IS COMPLETE CANAL CALCIFICATION TREATABLE? Many would look at this case and think that it is impossible to treat. This patient reported a history trauma which caused accelerated calcification and subsequent devitalization and infection of the tooth in question. The process of calcification is actually a protective mechanism used by the pulp (or “nerve”) to protect itself against further trauma. Consequently, it can make root canal treatment extremely difficult for the clinician who has to treat it years down the road. Although the task is difficult, and sometimes seemingly unable to be done, the characteristic of the reactive calcified material […]