endomontreal

Irreversible pulpitis, deep carie, deciduous restoration, broken lingual wall.

First molar with 4 root canals. Two mesial root canals no longer visible in middle and apical third with a curvature into “C” form. A file number 08 ISO follows a 90 degrees curvature in one of two distal root canals (per op. X ray dental film).

Persistent disease on second mandibular premolar. Tooth decay on abutment.

Risks of post removal include: fracture of the tooth, leaving the tooth non restorable, root perforation, post breakage, and inability to remove the post. An additional concern is ultrasonically generated heat damage to the periodontium. Therefore, an apicoectomy and retrofilling or an extraction and replacement with an implant or a fixed prosthesis is a treatment option before initiating the retreatment.

Post has been removed in 20 minutes.The use of ultrasonic energy for short periods and water cooling to prevent excessive amount of heat generation proved to be most efficient in this case.

A casted post and a new crown are planned.

Pre operative film shows a large bony defect (”J” type lesion?) with canals not visible in mesial root. An impressive soft tissues swelling of adjacent vestibular area was also noted. Endo treatment finished on the 16th of march 2009 with surgical operative microscope (three appointments were needed). Post operative control X ray film (16th of october 2009) shows a nice healing of surrounding hard tissues.

Persistent apical periodontitis. Patient unable to chew on this tooth. Endo retreatment (Ca(OH)2 for ten days). Symptoms subsided after 8 days. Mesiovestibular root canal has a curvature into an “S” form.

Symptomatic first maxillary premolar with deciduous extensive composite restoration (MODBL). This tooth needs a pre prosthetic endodontic treatment.

Dental operative microscope assisted localization of root canal entries. Ultrasonic tips, chelating agent and quite a few ISO K files were also needed. These teeth, when symptomatic or if in need of prosthetic treatment can now be preserved.