Unexpected Bleeding

May 30, 2021

At the end of the shaping and cleaning stages of root canal procedure, we should be able to dry the root canal system with sterile paper points. But, this is not always the case!

Unexpected bleeding intra-operatively can occur for a range of reasons…

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a discoloured tooth

Walking Bleach since 1938

May 11, 2017

Tooth discolouration as a result of intrapulpal hemorrhage (i.e. traumatic dental injuries, pulp necrosis, pulp tissue remnants after endodontic therapy, internal resorption, etc.) can be effectively and safely corrected with walking bleach (internal bleaching) technique. This technique is a conservative alternative to a more invasive esthetic treatment such as placement of crowns or veneers…

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perforated tooth

Not Every Hole is a Canal

October 26, 2013

Perforations or accidental communications need to be repaired as soon as possible in order to achieve the best possible prognosis. The choice of repair material depends on the location and the size of perforation. MTA is still one of the best materials that can be used to seal the pulp floor perforations as long as it is not communicating with the sulcus…

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lost crown

MTA… Saving Open Apices One Tooth at a Time!

June 26, 2013

Providing root canal treatment can be challenging in teeth with incomplete root formation. The apex is large and open, the canals walls are thin and fragile, and this makes disinfection and obturation hard to do. Before the advent of MTA, calcium hydroxide was used in teeth with open apices over a long period of time, anywhere from 6 months to 24 months, to induce a calcified barrier over the open root apex…

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needle irrigation

Irrigation…How Low do you Dare to Go?

May 2, 2013

I graduated from dental school years and years ago with a deeply instilled fear of perforation, a reluctance to tackle calcified teeth, and anxiety whenever I waited for my obturation film to emerge from the processor. Irrigating the root canal was the breeziest part of treatment, to my memory…

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permaflo purple

How do You “Seal” the Deal?

April 19, 2013

After we’ve spent so much time doing great endodontic treatment – with rubber dam isolation, perhaps gingerly applying OraSeal or Kool-Dam to make sure everything is water tight, carefully instrumenting, copiously irrigating, and then obturating with great style – how can we protect our painstaking work?

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munce burs

MB2, a Pain in the Neck

April 10, 2013

I was taught that MB2 canals in upper molars are there 60-70% of the time. Newer tools and techniques show us that MB2’s are always there whether or not we can get to it. As a matter of fact I tell our endodontic residents at UBC that “if you haven’t found it, you have missed it”…

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cervical resorption classes

The Pink Tooth

September 19, 2012

One of the reasons for a tooth appearing pink is the presence of External Cervical Resorption (ECR) or Invasive Cervical Resorption. This type of resorption has been described and classified by Heithersay.

Some of the predisposing factors for ECR include: trauma, orthodontics, periodontal therapy, surgical procedures, intra-coronal bleaching/restorations, etc…

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3 canal premolar

One Cone Fits All, or Does It?

July 22, 2012

A correct statement?
“After about ten years of first appearing on the market, currently Thermafil obturators are completely modified and form an integral part of a complete and sophisticated system of root canal obturation that, when used correctly, can give optimal results. — W. Ben Johnson”

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Thermafil removal

Alcohol is the Way to Go!

July 2, 2012

During re-treatment procedures, removing the gutta-percha dry (if possible) is preferred. Simply because it is less messy. But I often find myself use a bit of C-form (what we call chloroform in the office) specially when I have to negotiate the very last part of the gutta-percha close to the apex…

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intracanal CaOH

Calcium Hydroxide: What’s the Big Deal?

July 1, 2012

It is known that micro-organisms in irregular spaces beside the main canals and specially in lateral and accessory canals survive the limited effect of chemomechanical instrumentation. There are overwhelming amount of evidence in endodontic literature in support of the short-term use of CaOH (a week or longer)…

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the SEM of removed smear layer

The True Agents of Cleaning

June 18, 2012

The dentin mud or “smear layer” forms as a result of the action of endodontic instruments during root canal therapy. The debris (inorganic materials along with the pulpal tissues, bacteria, blood cells, etc.) that is formed is smeared against the canal surface during the cutting and planing actions of the endodontic files and instruments.

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post removal kit

Ruddle to the Rescue!

June 2, 2012

Removing posts from canals could be pain in the neck sometimes. There are many ways to remove a stubborn post from a canal such as cutting all the sound tooth structure around the post with a large round bur (I hope nobody is using this method) or using ultrasonic device…

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Too Hot to Handle!

May 30, 2012

After giving adequate block injections and local infiltrations, I usually use intraligamental or intraosseous type of injections. My first choice for a few years has been using a syringe called Paroject. This syringe is used for intraligamental injections which is in a way intraosseous as well since the pressurized anesthetic solution in the PDL space will penetrate into the adjacent cancellous bone…

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