An unfortunate example of how patient non-compliance can lead to poor outcomes So often I find myself reminding patients to avoid confusing ‘no pain’ with ‘no problem.’ Many dental and non-dental infections progress in an insidious manner, and timely intervention is critical regardless of symptoms. This case highlights that, as well as another [...]
A unique lesion mimicking a root fracture due to a patent furcation canal The MB2 canal of upper molars is highly variable. It can join the MB1 canal, it can be completely absent, and (as in this case) it can have its own separate foramen far short of the radiographic apex. This patient [...]
Surgical and non-surgical treatment of tooth #10 Some teeth require both non-surgical and surgical treatment to resolve an infection, especially if the lesion is cystic. In such cases, if root canal therapy doesn’t reduce the size of the lesion over time, or alleviate symptoms, apicoectomy and placement of a bioceramic retrofilling will lead [...]
An unclear prognosis of tooth #19 based on radiographic findings The shape, size, and location of an osteolytic lesion are all important in diagnosis, and thus treatment of dental infections. A radiolucency at the periapex of a tooth suggests an endodontic etiology, whereas a ‘J’ shaped lesion that spans the length of a [...]
Apical surgery and restoration of marginal caries on tooth #6 The maxillary canine is a strategic tooth and its premature loss can have significant restorative consequences. This patient came in for an unrelated issue, but it offered a chance to get 14 year recall on a surgery done at our office. This [...]
Root canal treatment of a necrotic incisor presenting with dens in dente This patient, an 18 year old male, presented without symptoms to our office in 2012 regarding a periapical lesion associated with #25. Examination revealed irregular root and crown morphology consistent with dens in dente--also termed ‘dens invaginatus.' Root canal treatment was [...]
Pulpal regeneration/revascularization of an immature molar…after instrumentation! A 13-year-old female presented in pain associated with a large cavity on tooth #18. Originally an MTA pulpotomy was planned for this tooth because of the open/incompletely formed apices; however, after coronal pulp removal, it was determined that the remaining pulp tissue was very hyperemic and [...]
Unusual anatomy of a mandibular second molar Nonsurgical root canal therapy was performed on #31. During the procedure a mid-mesial canal was detected just lingual to the mesio-buccal orifice, via troughing with an ultrasonic tip and the aid of a dental operating microscope. Radiographs were taken to reveal an abrupt, midroot canal curvature [...]
Unusual anatomy of a mandibular first premolar Nonsurgical root canal therapy was performed on #21 with unusual morphology. (See images 1-3) Pre-operative radiograph 2. Intra-operative radiograph 3. Post-operative radiograph Thorough knowledge of tooth morphology and root canal anatomy [...]
