Successful management of pain is a critical aspect of dentistry. This becomes a great challenge when patients present to clinic with a painful endodontic emergency. Management of acute symptoms of irreversible pulpitis can be difficult to manage especially in the posterior lower quadrants. As IANB success in patients with irreversible pulpitis can be as low as 30%. The…
Pediatric endodontics can be confusing and challenging. Choosing the right treatment plan is dependent on a multitude of factors: primary vs. permanent tooth, pulpal state, open vs. closed apex, estimated retention time for the tooth, and a variety of materials to use. To make things just a bit tougher, you’re usually dealing with a patient with limited cooperation and…
When practicing dentistry everyday, we can loose track of the foundational knowledge underlying routine procedures. Today, we hope to refresh your knowledge, by presenting a case that shows percise and clean dentistry. An endodontically treated tooth most often has a lot of missing tooth structure. The downfalls of cast posts to replace this structure are widely…
The following presentation is the first part of our case series on the management of ectopic eruption of teeth. Part 1 As we’ve discovered in our previous article, autotransplantation can be a viable means of replacing teeth. This procedure, however, requires a very technique sensitive protocol and management by means of multidisciplinary team and implementation of…
Bioactive bioceramics are materials that react with the tissue components. The “bioactivity” of the materials refers to its ability to create a hydroxyapatite layer when in contact with tissue fluid rich in calcium and phosphate. This property allows the material to be highly biocompatible, osteoinductive, osteoconductive, and contributes to its sealing ability. These materials also…
The following presentation is part of three case series on management of macrodontia of fused anterior maxillary incisors. Tune in each week as we discuss each unique scenario. Part 1 Macrodontia of anterior teeth may be an isolated condition or occur as a result of fusion, gemination, or concorcense of teeth. Just to refresh: Fusion of…
The primary goal of any dental treatment is to preserve the pulp or reverse any damage to it. In mature teeth, when there is a carious pulp exposure, the usual treatment is pulpectomy or root canal therapy. The consensus is that pulp capping (most often performed using calcium hydroxide), whether direct or indirect, doesn’t lead…
Case Presentation A 19-year-old man presented to the dental office with pain and swelling around tooth 4.6. The tooth had a history of an initial root canal treatment, 5 years ago, due to a diagnosis of symptomatic irreversible pulpitis. The tooth was retreated two times by endodontists, due to continued symptomatic apical periodontitis. Intraoral examination revealed a…
A 16-year-old girl presented to the clinic with a fistula on the apical third of her upper left central incisor. During clinical examination, a tubercle was seen on the buccal cervical third of the tooth. Radiographic and clinical examinations provided a diagnosis of apical chronic supurative periodontitis. Root canal therapy (RCT) of the upper left…
As endodontic systems and methods of disinfection advance, most endodontic failures are due to root or crown fractures, instead of re-infections. As clinicians we tend to make a significant compromise when doing root canal treatments. To gain straight-line (less than conservative) access in order to achieve close to complete disinfection, we compromise the rigidity of…