FIXING COMPROMISED CASES: This 50 y.o. healthy male presents with pain associated with the support tooth of his bridge. We have noted a 6 unit FPD with #5 and #6 used as pier abutments. We have diagnosed a recurrent infection associated with #6 secondary to a misplaced post causing a perforation on the disto-palatal aspect. As all potential options involving removal of the FPD would be very costly to replace, we made the decision to perform surgical repair of the perforated post. Root end preparation and retrofill was also done to seal off all potential communications from the canal system […]
Category: Endodontic Treatment
FIXING COMPROMISED CASES
INSTRUMENT REMOVAL
INSTRUMENT REMOVAL
INSTRUMENT REMOVAL – This patient presented to our office with a previously initiated RCT #19 with a separated retained instrument in the ML canal. Information regarding “pathophysiology” of instrument separation, risk-benefit ratio of removing the retained instrument, alternative options if instrument removal cannot be achieved (i.e. bypass and/or apicoectomy), and prognosis were reviewed with the patient. The patient was motivated to save his tooth at all costs. Upon access, the retained instrument was visualized in the ML canal. The instrument was successfully removed using ultrasonics and hedstrom files. The patient was pleased with the final result. […]
TRANSIENT APICAL BREAKDOWN
TRANSIENT APICAL BREAKDOWN
TRANSIENT APICAL BREAKDOWN: Here we present a case of a young healthy male who sustained facial trauma involving monkey bars and affecting tooth #9. He had subsequently had a splint placed at the ER to rectify a subluxation injury and was referred to our office for follow-up and necessary treatment. Upon initial evaluation, the tooth was still slightl symptomatic and tested negatively to pulp vitality testing. Additionally, there appeared to be a lesion on radiograph. As the traumatic incident was recent, we recommended that the tooth be re-evaluated at a future date (in this case 3 months) and instructed the […]
COMPROMISED CASES
COMPROMISED CASES
COMPROMISED CASES: Here we present a case where both restorative dentist and periodontist were a little unsure as to what could be done here with regards to the large resorption defect on the mesio-palatal aspect. Periodontal surgery was initially in the plan should the tooth be deemed restorable. We deconstructed the case via complete canal instrumentation, degranulation of the resorption defect, and medication with Ca[OH]2. On the second visit, we completed the root canal and repaired the defect with Brasseler Root Repair Material and sealed it with a dual cured core composite. At 8 weeks between treatment initiation and completion, the […]
Endodontist Competency in Implant Dentistry
Should my Endodontist to be Competent in Implants?
IS IT BENEFICIAL FOR YOUR ENDODONTIST TO BE COMPETENT IN IMPLANT DENTISTRY? Here we present a patient that was referred to our office for “retreatment” of tooth #30. Upon radiographic survey and clinical evaluation, the tooth was deemed non-restorable primarily due to recurrent decay in the furcation area causing a secondary bone loss. To ensure that this tooth was the only significant dental need, communication was made both to ensure adequate interoffice communication (i.e. approval) and to ensure that there is no other dental needs of higher priority. After being given the greenlight to proceed with the procedure, extraction was […]
A Patient's Guide to Apicoectomy
A Patient’s Guide to Apicoectomy
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Sedation Dentistry: Frequently Asked Questions
Sedation Dentistry: Frequently Asked Questions
It is estimated that around 30 million to 40 million individuals in the United States fear dental visits. If you are amongst this group, your anxiety might be keeping you from getting the regular dental care you need. This can lead to several potentially devastating dental issues in the future, including dental caries, gum disease, or even tooth loss. For many people, including those with dental anxiety, sedation dentistry is the best option. The following are a few frequently asked questions you might have about sedation dentistry. […]
Treatment Planning Dilemmas
TREATMENT PLANNING DILEMMAS
TREATMENT PLANNING DILEMMAS: Here we present a case with an initial presentation of a history of both non-surgical and surgical treatment (of the MB root). The patient’s chief complain included persistent pain. CBCT (not shown here) confirmed a lesion associated with the MB root. Interestingly, we also noted that surgery had been done on the MB canal but not he MB2 canal due to an incomplete root resection. The apical plug associated with the MB canal was intact. With the help of the patient’s lack of motivation to pursue surgery again, the decision was made to non-surgically retreat the case. One […]
Don't Know if You Need a Root Canal?
Don’t Know if You Need a Root Canal?
DON’T KNOW IF YOU need a root canal? These signs may just tell you. If you have any of them, don’t dismiss them and come see us as soon as possible! https://live-renovo.pantheonsite.io/ […]
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. […]
