Endodontic Treatment Archives | Page 6 of 8

Broken Instruments...or Modified Root Filling?

BROKEN INSTRUMENTS…OR MODIFIED ROOT FILLING?

Posted on March 22, 2018 (March 24, 2021) by Jonathan Wong

BROKEN INSTRUMENTS…OR MODIFIED ROOT FILLING? Here we present a relatively interesting case, #14, with a recurrent infection associated with the MB root. Other than pain associated with this tooth, medical history remains unremarkable. We were able to remove the “root filling” which appears to be endodontic instruments that may have also been used in initial instrumentation. In any case, we were able to remove the all three instruments and locate a previously untreated MB2 canal. This would prove to be significant as this it the only canal in the MB root that was able to be instrumented to full root […]

Endodontists and Permanent Restorations...

ENDODONTISTS AND PERMANENT RESTORATIONS…

Posted on January 28, 2018 (March 24, 2021) by Jonathan Wong

WHY IT IS USEFUL IF YOUR ENDODONTIST CAN DO PERMANENT RESTORATIVE TX: While as endodontists, we always defer core and crown fabrication to the restorative expert (the patients general dentist), we do offer core placement and crown repair for those dentists who request it of us. Here is a great example of why it can be useful to have the core build-up completed at the time of RCT. You will see intra-op photo (5 canal #14) compared with a 6 month recall with gross caries throughout the entire access after the patient failed to have the tooth restored in a […]

Restorative Complications with Endodontic Treatment

RESTORATIVE COMPLICATIONS WITH ENDODONTIC TREATMENT

Posted on January 11, 2018 (March 24, 2021) by Jonathan Wong

Here we present a healthy 18yo African American female in which non-surgical root canal treatment was rendered on #21 demonstrating a nice trifurcation anatomy. Some time later were we were contacted by the restorative dentist wanting us to re-evaluated the post/core placement prior to crown fabrication. As one can see, it appears that that something went awry while preparing the post space and large void had been left on the mesial aspect at mid-root level. We felt that this would compromise long term fractural resistance. Therefore, the post was removed and dual-cured core composite was placed to aid with fracture […]

Why is it Beneficial for Endodontists to be Proficient in Extractions and Socket Preservation?

WHY IS IT BENEFICIAL FOR ENDODONTISTS TO BE PROFICIENT IN EXTRACTIONS AND SOCKET PRESERVATION?

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

WHY IS IT BENEFICIAL FOR ENDODONTISTS TO BE PROFICIENT IN EXTRACTIONS AND SOCKET PRESERVATION? This patient presented to our office complaining of a draining sinus tract on the palatal gingiva of tooth #14. Clinically, tooth #14 had an isolated deep probing depth of 13mm on the palatal aspect with corresponding complete bone loss around the palatal root on the CBCT (not pictured below). The patient was advised that these findings are consistent with vertical root fracture and prognosis is hopeless. The patient was highly motivated to extract tooth #14 and restore with an implant. Although it is not a requirement […]

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 […]

Endodontic Healing Potential

ENDODONTIC HEALING POTENTIAL 3

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

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

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! […]

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 […]

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 […]