HOPELESS PROGNOSIS?: Based on the pre-operative PA, many dentists would suggest to their patients that this tooth has a poor or hopeless prognosis. Clinically it had a 12 mm probing to the apex and radiographically it has a large apical lesion that was confirmed to extend around the entire MB root on CBCT. Even more concerning was that the lesion was not well centered around the root apex and was localized around the lateral root surface. Frequently patients like this are told “This tooth is fractured, it has to come out” without even attempting endodontic treatment. This case presents a great […]
Category: Cool Cases
HOPELESS PROGNOSIS?
INTENTIONAL REPLANTATION
INTENTIONAL REPLANTATION
INTENTIONAL REPLANTATION: This is a great example of how a treatment approach that is not ‘in vogue’ in the implant era can still have a fantastic outcome. Root canal therapy was completed by this patient’s restorative dentist and the mesial root was not able to be negotiated due to moderate curvature. CBCT shows that the canals had been transported and ledged to the buccal and lingual but the patient wished to attempt retreatment. Unfortunately, the ledge/transportation could not be corrected during retreatment. In preparing this patient for a possible implant, intentional replantation was discussed as an alternative if we could […]
OROANTRAL COMMUNICATION CAUSED BY ODONTOGENIC PATHOLOGY
OROANTRAL COMMUNICATION CAUSED BY ODONTOGENIC PATHOLOGY
OROANTRAL COMMUNICATION CAUSED BY ODONTOGENIC PATHOLOGY– This patient presented for evaluation of tooth #3. His chief complaint was a painful swelling of gum that would sometimes bleed in the area of tooth #3. The patient reported RCT #3 was completed over 20 years ago by an Endodontist. The patient stated that he is congenitally missing teeth #4, 5, 12, and 13. The patient denies wearing an RPD. The patient’s chief complaint was consistent with a sinus tract located mesial to tooth #3 at the level of the alveolar crest. The sinus tract was traced with gutta-percha. Tooth #3 had an intact […]
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LAST CASE OF THE WEEK
LAST CASE OF THE WEEK
LAST CASE OF THE WEEK: Non-restorable #31 – Bridge sectioned between #29 and pontic #30 – #31 and residual root tip #30 extracted – Extraction site #31 grafted – Site #30 ridge augmented in preparation for dental implants to replace the existing FPD. […]
Another One Bites the Dust
ANOTHER ONE BITES THE DUST
ANOTHER ONE BITES THE DUST: I was actually thinking for moment to try and save this one…but the cost:benefit analysis for retreatment, perforation repair, new indirect restoration just didn’t seem worth it. Additionally with that much retention needed in the form of the post/core), there is surely a significant compromise in the lack of good tooth structure left to work with. We decided to go with the more predictable route here. […]
Thermafill retreatment #30 with some accessory portals
Thermafill retreatment #30 with some accessory portals
Thermafill retreatment #30 with some accessory portals. Root canal completion #31. More anatomy….. […]
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Lesion Shape Suggestive of Root Canal Anatomy
LESION SHAPE SUGGESTIVE OF ROOT CANAL ANATOMY
LESION SHAPE SUGGESTIVE OF ROOT CANAL ANATOMY: This is a pretty good demonstration of periapical lesion associated with the canine tooth (#6). Pre-operative radiographic survey reveals that the lesion is off to the side at the apical third. Post-operative radiograph highlights a couple accessory canals providing a route of infection and inflammatory response in the area of the lesion. Good demonstration of anatomy here. […]
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Double Curves
DOUBLE CURVES
DOUBLE CURVES: These are a couple recent cases demonstrating double curves at the apical third of the roots. Sticking to sound instrumentation techniques are really helpful in cases like these to avoid separating files within the canal system. […]
Renovo Now Offering Dermatological Treatments!
RENOVO NOW OFFERING DERMATOLOGICAL TREATMENTS!
RENOVO NOW OFFERING DERMATOLOGICAL TREATMENTS! This case is a highly unusual example of a mandibular odontogenic lesion causing an extraoral sinus tract. This patient had already been to see his dermatologist for two biopsies with inconclusive results. After the area continued to bleed for several months, he found our office. A necrotic #27 was noted with lesion expanding to tooth #28 which had an untreated lingual canal with a separated lentulo spiral at the apex. RCT of #27 with adjunctive apicoectomy was completed. During surgery, the chin sinus tract was bleeding as we removed the granulomatous lesion. At his post-surgical […]
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Patient Management and Endodontic Treatment
PATIENT MANAGEMENT AND ENDODONTIC TREATMENT
PATIENT MANAGEMENT AND ENDODONTIC TREATMENT: It is not always the anatomy that is difficult in the aspect of treatment. However, added factors can compound case difficulty such as minimal opening, unfavorable angulation towards the cheek, the position of being last tooth in the mouth, AND LONG (WL – 24mm) Curvy Calcified (MB2) Anatomy. At first glance, this just looks like a “run of the mill” root canal with some nice curvatures. However, it is important to note that we treat people, not just teeth. […]
