Sharing the Endodontic Knowledge

periapical cemental dysplasia

‘No’ Treatment is ‘The’ Treatment!

August 21, 2012

A patient presented with pain in the lower anterior area. A fairly good-looking and recent root canal (approx. over 2 months old) had been performed on tooth #4.2. Patient’s pain however had been progressively getting worse since the completion of treatment. The pain was not occlusion-related and analgesics had not been helping either…

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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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antibiotics in endodontics

Antibiotics: Knowing When Not To Use Them!

July 16, 2012

Inappropriately prescribing antibiotics is one of the main contributing factors in the development of antibiotic resistant microorganisms. The most effective treatment of endodontic infections are: removal of the source of

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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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post-op radiograph

How to Handle the Curves?

June 22, 2012

Some of you may wonder how a long root with moderate to severe curvature should be instrumented. Some clinicians may also be hesitant to use rotary instruments in such roots and therefore resort to using handfiles…

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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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access cavity photo

Lateral vs. Vertical: What Say You?

June 13, 2012

“Pure lateral or vertical compaction rarely occurs. The vectors of force applied during obturation techniques are an integrated blend of forces and result in composite of forces that are neither true vertical or lateral.” [Pathwyas of the Pulp-7th Ed.]

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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…

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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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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. ..

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Don’t Let the Sun Set on Pus!

May 28, 2012

A young female patient developed a very large and extremely painful swelling over night on the roof of her mouth. She had been in pain for a few days prior to the the development of swelling for which she had been placed on appropriate type and dosage of antibiotics…

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post-op x-ray

I Love Sealer Puffs!

May 26, 2012

Chemomechanical preparation partially removes necrotic tissue from the entrance of lateral canals or apical ramifications, whereas the adjacent tissue remains inflamed, sometimes infected, and associated with periradicular disease. Vital tissue in lateral canals or apical ramifications is not removed by preparation…

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