Case of the week part 14.

Fresh case after holidays :)  Lower first premolar. On the left picture is situation at the beginning. Patient is planning prosthetic reconstruction and have some pain in this region. GP asked me to retreat #44. I also checked vitality in #45 (looks bad to me) but it is vital! I told the patient that we will meet soon with #45 and start the party with #44. Always when I see parallel "shadow" to canal I search for additional one (black arrow). In this case both canals were very narrow and loooong (25,5 and 26 mm). I spend 2 hours on this case, but second picture looks pretty to me :)

Case of the week part 13

This case was made at single appointment. Patient was reffered to my office with some gutta-percha cone in medial canals. That was improper working length. Canals were very narrow, so i started to negotiate with #08 K-file, and then Endostar Five (Poldent) protocol. Final size/taper was 30.04 both in medials and distal one. After three years looks nice to me :)

Case of the week part 12

Sometimes internal tooth anatomy is different than standard. In this case in second maxillary premolar were two canals in apical third. Split was located very deep in RC. And curvature of apical third is in wrong direction ;)

Case of the week part 11

C-shape canal is not very common system. Most often We can ring it in lower second molars. In this case " : " version is present. Only two canals have an anatomical apex (one located medially and one distally), but between them is long isthmus. Rotary files can shape only main canals, rest should be chemically disinfected. Ultrasonic activation of sodium hypochlorite and warm gutta percha obturation are essential for me in that kind of anatomy. What is your "tips and tricks" with C-shape?

Overlay reconstruction

Reconstruction of missing tooth structure after RCT is also very important part of treatment. Indirect composite overlay is one of the best option. It covers all cusps and occlusal surface, and have more conservative approach than PFM crown. In this case it was cemented on dual cure composite cement.

Preparing for 2 days lecture

Last check up of presentation and stuff i need for 2 days hands on course of advance endodontics in magnification. Szczecin I am coming soon!

Case of the week part 10

Another nice healing. Two visits treatment with calcium hydroxide dressing. Canal shaped with Big Apical Files (Poldent) to size 50.04. Half year recall to check if surgery (apicoectomy) is needed. Patient doesn't feel any pain for percussion or palpation. Seems good to me :)