EndoLounge

A Compromised Tooth is Still a Tooth

February 21, 2017

Endodontic diagnosis for tooth #2-7: previously treated, symptomatic apical periodontitis. Intra-oral examination reveals a wide, 6 to 8mm clinical attachment loss (i.e. probing defect) distal to tooth #2-7 and loss of distal contact due to enamel fracture. A CBCT scan shows intact buccal and palatal bone and a significantly shortened palatal root due to external inflammatory root resorption…

The Little Devil Horn

October 30, 2015

Dens evaginatus (a.k.a. Leong’s premolar) is an odontogenic developmental anomaly. This anomaly, an enamel-covered tubercle with an extension of pulp horn in most cases, occurs primarily in premolars. Loss of this tuberculated cusp during natural root maturation and development will result in early pulp exposure, pulpal necrosis, periapical disease, and arrested root development…

It’s Vital…with No Fillings…but it Hurts!

September 19, 2014

Radiographs can be so deceiving! This radiograph of the first quadrant looks so calm, so unassuming… everything looks normal. What you didn’t see was the patient attached to this radiograph – having extreme, radiating pain. When everything looks fine on the radiograph, and we have a quadrant full of unrestored or minimally restored teeth, my spidey sense tells me to pick up a probe, and also a transilluminating device…

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…

How can an Apicoectomy Help?

June 4, 2013

There are times when conventional root canal treatment or retreatment cannot heal every periapical lesion out there. Luckily, we have the option of an apicoectomy – which in today’s terms, means microsurgery. During an apicoectomy, the most apical part of the root tip (usually about 3 mm) is removed…

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?

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…

$horizontal root fracture$

Is This a Hopeless Case?

June 5, 2012

“In traumatic dental injuries, not only it is important to know when to treat a case (endodontically-speaking); it is equally important to know when not to treat it.” – Martin Trope

Before considering extraction of a tooth with root fracture, no matter how bad it looks on the x-ray, the following treatment approach must be considered…

$vertical root fracture$

Oh No, Vertical Root Fracture!

May 29, 2012

We have all come across an endodontically-treated tooth with vertical root fracture (VRF). What gives the VRF away is the pattern of bone loss (more bone loss occlusally than apically) and the clinical attachment loss on the buccal or lingual aspects of a specific root. ..