Dr Pizem Advanced Endodontics Procedures
Root Canal Procedure. Case Study Number 29537.
Microendodontic. Calcified canals. Case Study Number 506846
Patient referred for endodontic treatment on this mandibular first molar. Coronal-radicular access was already done but canal entries are embedded in a mass of calcified dentine and could not be found.
Preoperative X ray dental film shows a complete mineralization of both mesial and distal canals coronal third. This is an intricate root canal procedure, because this pre operative condition involves dealing with complete canal stenosis caused by dystrophic calcifications.
Dental operative microscope (Opmi Proergo from Carl Zeiss) and ultrasonic tips where most helpful in locating both mesial and distal canal entries.
Once located, our first instrument in four canals were K files number 06 (second X ray dental film). Then, mesial and distal canals have been shaped and cleaned with the Pro Taper system (Maillefer) and lots of RC PrepTM. They were subsequently filled with gutta percha (lateral and vertical condensation) and Pulp Canal Sealer EWT TM
Third X ray dental film (Clark’s rule) shows all four treated canals.
Amalgam corono apical core build up is shown in last post operative X ray dental film. A crown is planned by patient regular dentist.
MicroEndodontics. Case Study Number 500446
A few days ago we were confronted to this three rooted mandibular first molar (Radix Molar or Radix Entomolaris), a rare anatomical variation of teeth, where a third supernumerary root is located distolingually in mandibular molars. Root canal system calcifications and a canal curvature with an “S” form made this endodontic procedure an extremely complex one.
In that specific case, endodontist operative microscope was most helpful when striving to find the fourth canal entry in distal root, allowing for us not to omit the fourth deeply embedded root canal. This microendodontic case study enlightens how dental operative microscope may assist the practicing dentist into a more secure root canal procedure for his patient.
Root Canal Procedure with Surgical Operative Microscope.
MicroEndodontic.
Case Study Number 156037.
Pre operative film shows a large bony defect reminding us the alleged pathognomonic “J” type lesion. Still, there was no deep and narrow pocket probing. Root canals are not visible neither in mesial or distal root (calcified canals)
First appointment post operative X ray dental film shows shaped and cleaned canal system with inserted intracanal calcium hydroxide.
Post operative control X ray film in December 2011 shows a nice healing of surrounding hard tissues. Endo treatment finished on 2007 with surgical operative microscope Opmi PROergo from Carl Zeiss.This root canal therapy attempt once more enlightens the huge advantages of microendodontics and calcium hydroxide therapy in order to save teeth with an apparent very bad prognosis.
Treatment protocol:
First appointment: Opening through metal bridge abutment, gaining access to pulp chamber, adherent pulpstones and embedded pulpstones removal, root canal entries locations, cleaning and shaping, rinsing, drying, intracanal medication insertion and provisional obturation material.
Second appointment: Intracanal medication removal, rinsing and final obturation with Pulp Canal Sealer from Kerr and gutta percha
Endodontic material and equipment:
Case Study Number 465016
Patient has been referred to to us in order to complete a previously started root canal treatment on completely calcified root canal system. Pulp chamber is obliterated with embedded pulpstones, root canals are not visible on preoperative X ray dental film, these are calcified canals.
Patient is given full knowledge of the possible risks and benefits of such a complex procedure. Patient is in pain and she wants to keep her own tooth and give an informed consent.
Dystrophic calcifications have been removed from pulp chamber with ultrasonic diamond coated tips. Operative field observation is enhanced with high magnification and coaxial xenon lamp illumination. Once located root canal entries had to be widened in order to progressively regain patency in each root canal. Second X ray shows our first instruments in the root canals, these are K Files 06. Canals have then been shaped to K file size 15 and calcium hydroxide inserted. Following appointment allowed us to finish shaping, cleaning and obturation of the root canal system. Final outcome can be seen on fourth X ray dental film.
Dental operating microscope (D.O.M.) assisted R.C.T., Dental operative microscope and retreatment, Root Canal Treatment Pre Therapy 17736-1
Dental operating microscope (D.O.M.) assisted R.C.T., Dental operative microscope and retreatment, Root Canal Treatment Per Therapy 17736-1
Dental operating microscope (D.O.M.) assisted R.C.T., Dental operative microscope and retreatment, Root Canal Treatment Post Therapy 17736-1
Dental operating microscope (D.O.M.) assisted R.C.T., Dental operative microscope and retreatment, Root Canal Treatment Post Therapy 17736-2
Root Canal Procedure on Calcified Canals.
Case Study Number 317736
Patient referred for pre prosthetic endodontic treatment on mandibular first molar.
Preoperative X ray dental film shows a complete mineralization of both mesial part of pulp chamber and mesial canals as well as a complete stenosis of distal canal(s?)
Dental operative microscope and ultrasonic tips where most helpful in locating both mesial and distal canal entries. First instrument in four canals are K files number 06 (second X ray dental film)
Third X ray dental film (Clark’s rule) shows all four treated canals.
Amalgam corono apical core build up (no post) is planned plus a crown.
Case Study Number 434426
Patient was refered to us to locate MB2 and DB canal entries with the help of a dental operative microscope. Calcifications had to be removed with ultrasonic diamond coated tips from the pulpal chamber floor in order to expose those canal entries.