A new Dental Operative Microscope (D.O.M.) assisted root canal treatment in a calcified maxillary incisor.
Microendodontic. Case Study Number 237122
Tooth is asymptomatic patient wants to replace this existing crown for esthetic purposes. Replacing this crown without doing any endo might just be the way. But after prosthesis removal, high magnification under a dental operative microscope abutment shows an horizontal crack close to the margin on its buccal aspect. Hence we do have to find a way to put a casted post in place. Creating a space for the post might create an open gate for bacteria or might disturb the microflora balance within the root canal. So what options do we have here?
Apicoectomy and a post space? Crown to length ratio on this tooth would become a problem if we had to resect last apical 4mm in order to do an apicoectomy and we cannot be certain to have obturated portal of exit with a retro prep and a retrograde filling. Not good enough to my opinion.
Extraction with an implant surgery? The great classical solution! Why bother? BUT, patient wants to keep her own tooth and cannot invest in an implant surgery.
Last but not least: The not yet embraced but very effective microendodontic approach. The dental operative microscope OPMI PROergo from Carl Zeiss with its magnified and coaxial Xenon illumination allowed for a great operative field observation and unequaled precise hand micro movements. As it can be seen in the last postoperative X ray dental film, root canal procedure as been performed with no collateral damage, a casted post is planned with a brand new PFM crown by the referring dentist.