endomontreal

Case study number 485946

Symptomatic mandibular molar, patient can't chew on that side. Referred to us for endodontic revision.

First appointment intervention steps:

Coronal-radicular access (access through PFM crown, access through coronal build up) taking great care not to perforate the previously weakened pulpal floor, gutta percha removal, locating DB, regaining patency in calcified distal canals to the apex without perforation or deviation, correcting step in apical third of mesiolingual canal, negotiation of mesial canals, CHX 2% irrigation, CHX 2% left in canal system for one minute, drying canals, insertion of calcium hydroxide dressing, provisional obturation (Cavit)

Second appointment intervention steps:

Removal of Ca(OH)2, CHX 2% for one minute, dry canals, cone fit checking and final obturation with Pulp Canal Sealer and Gutta Percha.

Small sealer overflow is a good warrant of apical seal.

Referring dentist is planning a fixed bridge 37, 36, 35 X. (Patient did not want an implant to replace missing #34)

An intricate root canal procedure. Case study number 119711

A Vertucci type V pulp space configuration can be described as follow: One canal leaves the pulp chamber and divides short of the apex into two separate distinct canals with distinct foramina (1-2). According to Vertucci’s study in 1984 on a 100 mandibular molars sample, the type V configuration in distal root, occured only in 8% of the teeth examined. 

X ray with ISO files number 08 and 06 in distal single canal of lower left first molar shows an apical split in its last apical third. This is another Vertucci’s class V canal configuration. Each part of the split in distal root has been individually cleaned and shaped. NiTi files allowed us to follow both right-angle curves. Root canals have been obturated with Pulp Canal Sealer and gutta percha. (Lateral and vertical condensation). Last (Angulated) X ray to the right shows the obturated split as well as an anastomosis mesio vestibular and mesio lingual canals. ( a Vertucci’sType II canal configuration)

Interconnecting MB and D canals with two distinct portals of exit and very sharply curved canals.

Multiple portals of exit in distal root and severe curves in mesial root in a mandibular second molar. Refering dentist asked us to restore the tooth. Casted gold post and a gold crown with a long bevelled edge margin. Crown and casted post by Dental Ceramic Studio in Westmount.

Multiples puertas(sitios ) de salida en la raiz distal y muchas curvas en la raiz mesial en el segundo molar mandibular(inferior); lo que hace del tratamiento ser mas complicadol. referido al odontologo para la restauracion del diente. Poste moldeado en oro y una corona en oro con un largo biselado marginal. Corona y poste hechos por Dental Ceramic Studio en Westmount (Montreal)

Intricate endodontic procedure, case study number: 417

A Vertucci type V pulp space configuration can be described as follow: One canal leaves the pulp chamber and divides short of the apex into two separate distinct canals with distinct foramina (1-2). According to Vertucci’s study in 1984 on a 100 mandibular molars sample, the type V configuration in distal root, occured only in 8% of the teeth examined. In the apical third of distal root, each part of the split as been individually cleaned, shaped and filled with Gutta Percha and Pulp Canal Sealer. 

This is a very long tooth, it's position in the arch (second molar), it's sharp curve and it's apical third split in distal root canal, are all factors wich are listed in the high difficulty category of the American Association of Endodontists (A.A.E.) Endodontic Case assessment Form. Thus, this specific case, according to the American Association of Endodontists, present exceptionally complicated preoperative condition, exhibiting several factors listed in the HIGH DIFFICULTY category.

An intricate root canal procedure. Case study number 011820

A Vertucci type V pulp space configuration can be described as follow: One canal leaves the pulp chamber and divides short of the apex into two separate distinct canals with distinct foramina (1-2). According to Vertucci’s study in 1984 on a 100 mandibular molars sample, the type V configuration in distal root, occured only in 8% of the teeth examined. In the apical third of distal root, each part of the split as been individually cleaned, shaped and filled with gutta Percha and Pulp Canal Sealer. 

Lower left right molar shows an apical split . What we have here is a class V Vertucci's canal configuration in distal root, and a Vertucci's class II canal configuration in mesial root of a lower left right molar. Each part of the split in the distal root canal has been individually cleaned shaped and obturated with Pulp Canal Sealer and gutta percha. (Lateral and vertical condensation) Last (Angulated) Xray to the right shows the obturated split.

A very nice anastomosis of MB and MB2 merging to create this exquisite shape in an angulated X Ray film.