3 reasons why we have teeth: 1) Esthetics 2) Function: allows you to speak and eat 3) Stability: keeps other teeth from moving around. Bottom line? When you can’t save the tooth…replace it… […]
Category: Endodontistry
3 reasons why we have teeth
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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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 […]
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What You Didn't Know About Molar Anatomy
WHAT YOU DIDN’T KNOW ABOUT MOLAR ANATOMY
WHAT YOU DIDN’T KNOW ABOUT MOLAR ANATOMY CBCT is slowly becoming the standard of care for endodontics for many reasons. In a tooth with a somewhat unusual root shape, such as the case demonstrated here, CBCT helps us determine the number of canals so that we can keep our accesses minimal and make informed decisions of where to look for accessory canals such as an MB2. This tooth had a conical root shape so a CBCT was taken to determine anatomy. As you can see below, this is a highly unusual anatomy where the DB root bifurcates to form four […]
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. […]
INVASIVE CERVIAL RESORPTION
INVASIVE CERVIAL RESORPTION
INVASIVE CERVICAL RESORPTION: Here is an interesting case. This patient ended up in our care after a root canal was done on tooth #9. He was informed at that time that it wasn’t guaranteed that the tooth could be saved and that a dental implant might be necessary or a surgery of some sort. As one can see on the pre-operative radiographs, sagittal slice of the CBCT and clinical photo, there is clear evidence of invasive cervical resorption on the buccal aspecdt extending below… the level of the crest. Additionally, the granulation tissue was not addressed via non-surgical access. Because […]
Compromised Teeth
Restorative Considerations
Compromised teeth: Many times the limiting factor in the prognosis of teeth requiring endodontic treatment is the restorative aspect. Here we present a case in which rerstorability may be in question becuase fo the fractured portion of the crown. As part of the endodontic treatment, we repaired the portion of the crown prior to initiating the endodontic treatment. The endodontic treatment is quite standard, but we would like to point out the soft tissue response of our repair at 6 weeks when the case was completed. The difference betweent he pre-operative photo and the 6 week follow-up is significantly different […]
CBCT Imaging
CBCT Imaging
CBCT IMAGING – As many of us are aware, CBCT imaging applications for dentistry are growing at an exponential rate. This case highlights an unusual scenario where the patient received an apicoectomy on tooth #9 ~25 years prior to presentation. His chief complaint was a large sinus tract that had recently developed. Convential PA shows a moderate diameter lucency around the root apex. However, the …CBCT volume highlights an existing osseous graft (later revealed to be bovine bone graft through histology) that is infected and encapsulated by soft tissue. The native bone destruction is actually quite large and perforated on […]
