toothoughts toothoughts

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TOOTHoughts are better than 1  πŸ—½Endodontist πŸŽ“UPENN Let's talk all things Endodontics! DM YOUR CASES πŸ“₯ (The Good, The Bad, The Frustrating) "Cause everyone can use a 2nd opinion"

Some real restorative work needs to be done to save this tooth, but not everyday you see a DB2! πŸ¦‘πŸ™

Nice collaboration between endo, Perio, and restorative with 6 month recall (right). Complete PAP resolution and a well-fitting coronal restoration after crown lengthening. #teamwork πŸ‘Œ

Who would do a root canal on a Tiger?? This is amazing!Β πŸ™€

Another example of the importance of 3D scanning. What was a more difficult diagnosis based solely on the PA (left) was a slam dunk diagnosis based on the scan (right). PAP immediately noted and RCT #15 initiated. Patient is now asymptomatic.

Back2back- #14 and 15 completed in same single visit. Restorative will need to see this patient ASAP for proper coronal restorations. πŸ€™

Finding an apical split shouldn't be lucky- MAKE YOUR OWN LUCK TODAY! πŸ€

Let's talk resorption. I'm seeing this presentation more and more lately and it's almost always misdiagnosed! This is not caries and it's not ext inflammatory resorption. This is ECIR (extra-canal invasive resorption). It is a resorption originating from the PDL and usually presents with a VITAL pulp. Treatment in this particular case would include RCT, mechanical debridement, and chemical debridement using TCA (tri-chloro acetic acid). CLICK LINK IN BIO FOR A GREAT ARTICLE ON ECIR πŸ‘†

Nice submission by @endolady87 of retreats #29 and 30 complete with signature πŸ‘‘πŸ‘‘
Pleasure in the job, puts perfection in the workπŸ’«
#retreatment #rct #endolady #endodontia #endodontic #endodontist #molar #premolar #guttapercha #dentalcases #dentistrysociety #dental #endodonticresidents #ilovemyjob #rootcanal #rootcanaltreatment

4 year followup! 12 y/o patient initially presented with necrotic #22 with immature wide open apex, acute apical abscess. 25mm length with thin fragile dentinal walls. Did not feel comfortable enough to even pack MTA at the time. Decided to do an old school Calcium Hydroxide apexification, changing medicine every 3-4 weeks for 18 months. After 18 months, enough of a dentinal bridge was present to pack MTA and GP against. Pt is now 16 y/o asymptomatic, no PAP, no swelling, and apical closure can be seen.

Retreat #30- post removed through the crown with ultrasonics. Original treatment had missed distal split.
MY ADVICE: Use a combination of 6,8,10 C and C+ files. Most companies make the C files (lesser taper for calcified canals) and I recommend Maillefer for C+ files. DM for more info.

Happy Birthday America! πŸŽŠπŸŽ‰

Thanks to @drjasonforeman_endo for submitting this very interesting case! πŸ‘‡Separated file close proximity to IAN 😰
Broken file 30 + years ago.
#19 previous RCT / Asymptomatic Apical Periodontitis

No signs of paresthesia.

#20 RCT was initiated by referring GP and medicated with Ca(OH)2. Recommending extraction #19, graft, implant.

Top: Pre-Op PA radiographs
Bottom: Sagittal and coronal CBCT views of the separated file apical to #19 distal root in close proximity to the IAN

#closecall #cbct #diagnosis #silverpoints #ouch
#dental #endodontist #dentist #endodontics #endodontia #rootcanal #rootcanalspecialist #microscopicendodontics #illinoisrootcanal #champaignendodontist #endodontia #stainlesssteel

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