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OPMI PROergo Dental Operative Microscope VS Extreme Root Canal System Stenosis on a Maxillary Molar

September 1, 2011 By Dr Pierre Pizem 1 Comment

Dental operating microscope (D.O.M.), D.O.M. versus completely calcified systems, Root Canal Treatment Pre-Therapy 27526-1  Dental operating microscope (D.O.M.), D.O.M. versus completely calcified systems, Root Canal Treatment Per-Therapy 27526-1  Dental operating microscope (D.O.M.), D.O.M. versus completely calcified systems, Root Canal Treatment Per-Therapy 27526-2  Dental operating microscope (D.O.M.), D.O.M. versus completely calcified systems, Root Canal Treatment Post-Therapy 27526-1

A New Dental Operative Microscope (D.O.M.) Assisted Root Canal Treatment in a Calcified Maxillary Molar Abutment.
Microendodontic. Case Study Number 27526

Acute pain on this maxillary molar is keeping the patient awake all night long. Pain started following a recent filling replacement.  This is an irreversible pulpitis diagnosis, patient has been referred for endodontic therapy with the help of a dental operating microscope.

Radiographic findings: Dystrophic calcifications in the whole canal system are completely obliterating the pulp chamber as well as the root canals themselves. It can be expected that the root canal entries are completely embedded in a mass of adherent pulp stones. Root canal procedure is difficult because of calcified canals.

Endodontic procedure problem number one to solve: Exposing color map of dentin prior to locating root canal entries without perforating pulpal chamber floor and without destroying to much sound tooth structure in order to keep tooth restorable.

Endodontic procedure problem number two to solve: Cleaning and shaping located root canals without loosing patency, without breaking an endodontic file and without perforating the root. 

A few years back, when there was no surgical operating microscope in our dental practices and only a handfull of daring (and caring)  pioneers in microendodontics trained by Dr Garry B. Carr (who is an endodontist acknowledged to me as the “father of microendodontics”), removing this symptomatic molar and replacing it  by an implant supported crowns would have been a good option to consider for most of us. 

In order to save that tooth, calcified dentin must be carefully removed with long thin ultrasonic tips under the high magnification of dental operating microscope (OPMI PROergo from Carl Zeiss). No rapid technique exists for dealing with calcified root canal systems. Root canals where shaped and  cleaned with Protaper endodontic files and 06, 08,10  K in combination with chelating agent (RC PREP). Canal system has then been filled with Pulp Canal Sealer and Gutta percha laterally and vertically condensed. Provisional filling material: Cavit.

Last X Ray dental film is a post operative control, a crown with a perfect fit that was done by the referring dentist will warrant a good seal.

Filed Under: Dental operating microscope (D.O.M.) assisted R.C.T., Extreme endo clinical cases, NEW CASES, Root canal systems calcifications, D.O.M. versus completely calcified systems Tagged With: Adherent pulpstones, calcified canals, calcified dentine, complete root canal stenosis, Dental operative microscope, dentin, dentin map, dentin maps, Dystrophic calcifications, endodontic files, Endodontics, Endodontist, gary carr, Gutta percha, Images, microendodontics, Opmi Proergo microscope, pro taper, Protaper dentsply, pulp canal sealer, Root canal, root canal perforation, root canal procedure, Root canal system calcifications

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Comments

  1. Operating Microscope says

    January 15, 2014 at 9:54 am

    The job of dentist is really difficult but appreciable. It requires healthy environment and dental equipment is used in safe way. Many patient suffering from dental problems. Thanks for sharing such great information.

    Reply

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